Drug-Related Problems and Their Preventability among Admitted Patients in Paediatrics Department of a Tertiary Care Institute from Eastern India -A Prospective Study

Abstract

Patients with different manifestations and different diagnoses are admitted in Paediatric department. In admitted cases, drug therapy usually consists of multiple drugs including antibiotics, anticoagulants, glucocorticoids, antihypertensive, anti-diabetics, etc. Due to the prescription of multiple drugs, the chance of drug interactions is high. Early detection of DRP can help prevent any harm to patients. It is therefore possible to thoroughly evaluate various drug-related problems and prevent some of them in the paediatric inpatient department. The aim was to find out the drug-related problems during management of patients under paediatric department, to find out the magnitude and preventability. In addition, we hoped to provide insights into the DRPs encountered among hospitalized paediatric patients that can help in finding the appropriate solutions. All children's medical records were identified, collected and analyzed by trained clinical pharmacologists to identify DRP according to the well recognized and appropriate criteria system established by the Pharmaceutical Care Network Europe (PCNE). For standardization, patient demographics (age, gender, location and diagnosis) were recorded using WHO ICD version. Drugs were grouped into different categories using the Anatomic Therapeutic Chemical (ATC) classification (WHO-ATC). Descriptive analysis was done to summarize the findings of this study. Of 534 patients, 193 patients (36.1%, 193/534) had at least one DRP. A total of 262 DRPs were identified in 193 patients, of which 230 DRPs (87.8%, 230/262) were considered preventable. he vast majority of DRPs were related to dose selection (74.78%, 172/230). The second most common cause was related to drug choice (23.04%, 53/230) and drug use (2.5%, 5/280). We found that an increase in the number of drugs also increases the chances of having DRP by 1.31 times (95% CI, 0.89 to1.81, P=0.00005). There is high incidence of preventable drug related problems which is generally ignored if not thoroughly investigated. Most of the DRPs are associated with dosing and drug choice problems.