Identification and Resolution of Drug Related Problems in Pediatric Hematology/Oncology Ward of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
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Date
2019-01
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Addis Ababa University
Abstract
Even though, medications play a major role in the cure, palliation and inhibition of disease, they also expose patients to drug related problems. Drug related problems are frequent and may result in reduced quality of life, and even morbidity and mortality. Many studies have shown that clinical pharmacists can effectively identify and resolve clinically significant drug related problems. There is no data regarding drug related problems in pediatric cancer patients in Ethiopia. This study was aimed to identify and resolve drug related problems in Pediatric Hematology/Oncology ward of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A prospective interventional study was used to assess drug related problems on patients admitted at the Pediatric Hematology/Oncology ward of Tikur Anbessa Specialized Hospital between 25 June to 25 October, 2018. Data were obtained from the patients’ medical chart, physician, patient/care giver, pharmacists and nurses. All the collected data were entered and analyzed using the Statistical Package for the Social Sciences version 25 software. Among the total 156 participants, Drug related problems were identified in 68.6% of the study subjects. Dosing problems which includes dosage too low and high were the top ranking (39.3%) of all drug related problems followed by needs additional therapy (27.2 %) and non-adherence (14.0%). Anti-infectives for systemic use were the most common drug classes involved in drug related problems followed by antineoplastic and immunomodulating agents. Trimethoprim-sulfamethoxazole, methotrexate, vincristine, ondansetron and metoclopramide were the top ranking drugs involved in drug related problems. Addition of drug and change in drug dose were the two most proposed intervention types. Among the proposed interventions, 223 (92.15%) were fully accepted, 9 (3.72%) partially accepted and 10 (4.13%)not accepted. Length of hospital stay (AOR = 30.63, 95%; CI: 6.72, 139.63; P=0.000) was found to be a risk factor for occurrence of drug related problems. Drug related problems are common among Pediatric Hematology/Oncology ward patients. The study also demonstrated that clinical pharmacists can effectively identify and resolve clinically significant dug related problems. Length of hospital stay is an important risk factor for DRPs, but there is no significant
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association between occurrence of DRP and sex, age, presence of neutropenic fever in the study subjects
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Keywords
Drug related problems, Pediatric Hematology/Oncology ward, Tikur Anbessa Specialized Hospital