Drug Related Problems and Reactive Pharmacist Interventions for Inpatients Receiving Cardiovascular Drugs

Although pharmacotherapy in cardiovascular diseases can improve the well being, its benefit can be compromised by drug-related problems (DRPs). The objectives of the present study were to examine the number and nature of drug related problems in patients with cardiovascular diseases and to demonstrate the role of pharmacist in ensuring safe and efficient use of medicines in daily practice in the inpatient settings. A prospective cross sectional study was carried out for 8 months in the general medicine department of a 640 bedded multi-specialty private corporate hospital. The nature, prevalence and incidence of DRPs were studied and documented using the PCNE (Pharmaceutical Care Network Europe Foundation) classification system. A total of 1051 drugs were prescribed during the study period. Most commonly prescribed categories of drugs were antihypertensive (21.05%), anticoagulants and antiplatelet drugs (11.13%), antiulcers (8.84%), insulin and oral hypoglycemic agents (6.95%) and anti infectives (5.42%). Drug interactions (46.19%), drug over dosage (17.26%) and drug duplication (11.17%) were the most frequently occurring DRPs. Most common clinical risk factors identified were polypharmacy (66.21%) and diabetes mellitus (20.31%). Antihypertensive presented the highest drug risk ratio. Statistical analysis showed positive correlation between age and number of DRPs in the study population. Pharmacist interventions were mostly on drug interactions, dosing and drug choice and 59% of them were accepted, resulting in prevention of DRP occurrence. The current study demonstrated the importance of routine medication review and the need of a pharmacist in a multidisciplinary team in treating cardiovascular diseases. Key words: Drug related problems; cardiovascular diseases; drug interactions; clinical risk factors