Effectiveness of Pharmacist-led Intervention on Physicians Prescribing for Outpatients in Vietnam: A Before- and After-intervention Study
DOI:
https://doi.org/10.31584/jhsmr.20241038Keywords:
drug-related problem, outpatients, pharmacist, prescriptions, VietnamAbstract
Objective: Drug-related problems (DRPs) can lead to treatment failures and high risks of hospitali-zation. This study aimed to evaluate the effect of pharmacist-led interventions on DRPs in outpa-tient prescribing and to determine the risk factors relative to these DRPs.
Material and Methods: A prospective study was conducted that compared before- (April 1 to June 30, 2020) and after- (June 1 to June 15, 2021) interventions on the outpatient prescribing process from a public hospital in Vietnam. The PCNE classification version 9.1 and suitable drug information were used to determine DRPs, which then used Drugs.com to find drug-drug interactions for each prescription. Collaborated with hospital pharmacists via reporting on the pre-intervention results, sending information sheets, and reminding doctors of the DRPs was conducted.
Results: 32.8% of prescriptions had at least 1 DRP in 500 pre-intervention prescriptions. In 500 post-intervention prescriptions, the proportion of at least 1 DRP prescription decreased from 32.8% to 31.0% (p-value>0.05). Prescriptions with ≥5 drugs increased the possibility of a DRP appearance (p-value<0.001).
Conclusion: This intervention method was not thorough, so it was ineffective in reducing DRPs on outpatient prescriptions. It is necessary to conduct specific interventions on each DRP and more time to discuss with doctors to improve the effectiveness of prescribing.
References
PCNE. Pharmaceutical Care Network Europe. [homepage on Internet]. Basel: PCNE; 2019 [cited 2020 April 3]. Available from: https://www.pcne.org/upload/files/413_PCNE_classification_V9-1_final.pdf.
Bekele F, Fekadu G, Bekele K, Dugassa D, Sori J. Drug-related problems among patients with infectious disease admitted to medical wards of wollega university referral hospital: prospective observational study. SAGE Open Med 2021;9:1-8. doi: 10.1177/2050312121989625
Nguyen NA, Nguyen T, Pham ST, Nguyen TH. Pharmacist-led interventions to reduce drug-related problems in prescribing for Vietnamese outpatients. Pharm Sci Asia 2022;49:106-13.
Yismaw MB, Adam H, Engidawork E. Identification and resolution of drug-related problems among childhood cancer patients in Ethiopia. JJ Oncol 2020;2:1-9.
Budiastuti RF, Radji M, Purnamasar R. The Effectiveness of Clinical Pharmacist Intervention in Reducing Drug Related Problems of Childhood Acute Lymphoblastic Leukemia Patients in Tangerang District General Hospital, Indonesia. Pharm Sci Res 2019;6:28–35.
Aguiar KDS, Santos JMD, Cambrussi MC, Picolotto S, Carneiro MB. Patient safety and the value of pharmaceutical intervention in a cancer hospital. Einstein 2018;16:1-7.
Santos NSD, Marengo LL, Moraes FDS, Barberato-Filho S. Interventions to reduce the prescription of inappropriate medicines in older patients. Rev Saude Publica 2019;53:1-15.
Vietnam Ministry of Health. Decision No. 4041/QD-BYT Approving the project to strengthen the control of prescription drugs and prescription drug sales for the period 2017-2020 Hanoi: Vietnam Ministry of Health; 2017
Ertuna E, Arun MZ, Ay S, Kayhan Koçak FO, Gökdemir B, İspirli G. Evaluation of pharmacist interventions and commonly used medications in the geriatric ward of a teaching hospital in Turkey: A retrospective study. Clin Interv Aging 2019;14:587-600.
Abunahlah N, Elawaisi A, Velibeyoglu FM, Sancar M. Drug-related problems identified by a clinical pharmacist at the Internal Medicine Ward in Turkey. Int J Clin Pharm 2018;40,360–7.
Stämpfli D, Boeni F, Gerber A, Bättig VAD, Hersberger KE, Lampert ML. Contribution of Patient Interviews as Part of a comprehensive approach to the identification of drug-related problems on geriatric wards. Drugs Aging 2018;35:665–75.
Kusumawardani LA, Andrajati R, Nusaibah A. Drug-related problems in hypertensive patients: A cross-sectional study from Indonesia. J Res Pharm Pract 2020;9:140-5.
Mekdad SS, Alsayed AA. Quality Improvement project to reduce drug-related problems (DRPs) and potentially inappropriate medications (PIMs) in Geriatrics Cardiac Clinic in Saudi Arabia. Can Geriatr J 2019;22:49.
Sagita VA, Bahtiar A, Andrajati R. Evaluation of a clinical pharmacist intervention on clinical and drug-related problems among coronary heart disease inpatients: a pre-experimental prospective study at a general hospital in Indonesia. Sultan Qaboos Univ Med J 2018;18:82-7.
Nguyen NA. Evaluation of the effectiveness of clinical pharmacological interventions on outpatient drug prescriptions at the Hospital of Can Tho University of Medicine and Pharmacy. Ho Chi Minh City: The University of Medicine and Pharmacy; 2019.
Le VTT. Evaluation of the effectiveness of pharmacist interventions on drug-related problems of outpatients at Children’s Hospital Can Tho City. Ho Chi Minh City: The University of Medicine and Pharmacy at Ho Chi Minh City: 2020.
Truong HT. Study on clinically significant drug interactions and related factors in outpatient prescriptions at a city medical center in Hau Giang province in the year 2019 – 2020. Can Tho J Med Pharm 2020;32:60-7.
Truong TTA, Diep HG, Vuong HTK, Le TV, Vo QV, Nguyen NA, et al. Drug interactions in the treatment of outpatients with coronary heart disease in Can Tho. Can Tho J Med Pharm 2020;28:143-8.
Vietnam Ministry of Health. Circular No. 30/2018/TT-BYT promulgating the list and payment rates and conditions for pharmaceutical drugs, biological products, radioactive drugs, and tracers within the scope of benefits of participants of Medical Insurance Economic; Hanoi: Vietnam Ministry of Health; 2018.
Vietnam Ministry of Health. Vietnamese National Drug Formulary. Medical Publishing House; 2018.
Vietnam Ministry of Health [homepage on Internet]. Hanoi: Vietnam Ministry of Health; 2019 [cited 2020 March 10]. Available from: https://kcb.vn.
Drugs.com [homepage on Internet]. Auckland: Drugsite Limited; 2019 [cited 2020 March 10]. Available from: https://www.drugs.com/.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
