Résumé
Objective:To analyze the role of clinical pharmacists played in the drug consultation and advice in orthopedic ward in order to discuss the work mode and the effects of clinical pharmacists in orthopedic ward and improve the service quality of clinical pharmacy. Methods:The work records related to the drug treatment of clinical pharmacists were collected during January 2013 and December 2015. The aspects of service objects, involving drugs, issue categories and the results of feedback were summarized and analyzed.Results:The study summarized 504 work records of clinical pharmacists participating in the drug treatment in orthopedic ward. The rational use of antimicrobial drugs,analgesics and anticoagulants was the key work for clinical pharmacists. Frequently asked questions were drug selection, dosage, treatment plan, drug information, precautions and contraindications, pharmacological effects,adverse drug reactions and drug interactions. The advices of clinical pharmacists were accepted by orthopedists regularly, and the drug treatment regimes were improved with the help of clinical pharmacists. Conclusion:Clinical pharmacists participating in clinical practice can improve rational pharmacotherapy, and also contribute to the cultivation and improvement of self-quality of clinical pharmacist.
Résumé
Background: In India, a proper reporting of medication errors in the hospital is not available. Drugs worth crores of rupee are consumed every year but a substantial part of these drugs are irrationally prescribed. In order to promote rational drug usage standard policies on use of drugs must be set, and this can be done only after the current prescription practices have been audited. The prescriptions were analyzed based on the objectives of the study in order to promote rational use of drugs in a population. Methods: The study was carried out prospectively over a period of two months and 15 days in general medicine OPD of our tertiary care hospital. A specially designed performa was used with pre-inserted carbons. Results: Two hundred and thirty seven prescriptions were analyzed. Total no. of drugs in 237 prescriptions were 1001. Therefore average number of drugs/prescription is 4.22. Drugs were prescribed by generic names in 3.79% of cases, drugs on EDL are only 53.25% and fixed dose combinations are 26.87% of total drugs. Dosage forms used were mostly oral -93.51%. Injectables were only 6.19% and topical forms were least 0.299%. Doctors profile indicates that maximum number i.e. 93.67% were general practitioners. Basic information of patient was written in 72.57% prescriptions. Complete diagnoses were written in 70.04% prescriptions. Only 88.61% prescriptions were legible and only 76.79% prescriptions were complete in terms of dose, route, strength, frequency and dosage forms. Disease pattern seen was variable. Diseases of respiratory system were maximum 44.72 % followed by infectious and parasitic diseases - 16.03 % and diseases of digestive system - 13.92 %. The most common drug groups prescribed were NSAIDs± serratiopeptidases, antibiotics, antihistaminics, multivitamins, minerals, enzymes and expectorants & bronchodilators. The incidence of polypharmacy was also common with maximum number of drugs which were prescribed per prescription were four in 39.24% of prescriptions. The prescriptions also had other minor anomalies. Conclusions: This study showed that there is scope for improvement in prescribing patterns in areas of writing generic names of drugs, essential drugs, writing legible and complete prescriptions. Polypharmacy was also evident from our study. Establishment and implementation of appropriate clinical guidelines, use of essential medicines list, public education about medicines and regular update to the clinicians will help in implementing the principles of rational pharmacotherapeutics.