Pharmacist Interventions for Prevention of Drug-Related Problems and Cost Avoidance among Cardiovascular Patients at Queen Sirikit Heart Center, Khon Kaen University
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Abstract
Cardiovascular patients often undergo complex pharmacotherapy, which increases the risk of Drug-Related Problems (DRPs) and subsequent healthcare costs. Given the limited economic data on pharmaceutical care outcomes in this population, evaluating cost avoidance is crucial to reflect the profession's economic value and support the allocation of the pharmacist workforce. Therefore, this study aimed to analyze the types of DRPs identified through pharmacist interventions and to evaluate the cost avoidance in outpatients at the Queen Sirikit Heart Center of the Northeast, Khon Kaen University. Methods: A retrospective study was conducted over a one-year period (October 1, 2020, to September 30, 2021). Data were collected from outpatient prescriptions involving DRPs documented in pharmacist intervention records and computer key-in errors. The types of DRPs and associated medications were analyzed using descriptive statistics. Additionally, cost avoidance was calculated using an equation based on the probability of potential adverse drug events. Results: Out of 80,737 reviewed prescriptions, 9,400 computer key-in errors (11.64%) and 860 DRPs requiring pharmacist interventions (1.06%) were identified. Patient counseling and monitoring needs (24.77%) and inappropriate dosing, including over- and under-dosing (24.18%), were identified as the two most common DRPs requiring pharmacist intervention. The top five medications most commonly associated with problems were warfarin, atorvastatin, carvedilol, insulin, and amiodarone, respectively. Regarding economic outcomes, pharmacist interventions generated a total cost avoidance of 10,337,200 THB per year. This comprised 7,205,200 THB from resolving key-in errors and 3,132,000 THB from managing DRPs. Interventions related to over-dosing yielded the highest value of cost avoidance. Conclusion: Pharmaceutical care, systematically delivered through prescription reviews and pharmacist interventions, effectively prevents and resolves DRPs. Furthermore, it results in cost avoidance, thereby enhancing both medication safety and the overall quality of care for cardiovascular patients.
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