Pharmacist-Led Interventions to Reduce Drug-Related Problems in Prescribing for Pediatric Outpatients in a Developing Country: A Randomized Controlled Trial.

Q2 Medicine Journal of Pediatric Pharmacology and Therapeutics Pub Date : 2023-01-01 DOI:10.5863/1551-6776-28.3.212

Phuong Minh Nguyen, Kien Trung Nguyen, Suol Thanh Pham, Vy Tran Thanh Le, Tu Cam Thi Le, Han Gia Diep, Ngoc Nguyen Minh Le, Hung Huynh Vinh Ly, Trang Thi Nhu Nguyen, Anh Nhut Lam, Thao Huong Nguyen, Thang Nguyen

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Abstract

Objective: To evaluate a pharmacist-led intervention's effectiveness in reducing drug-related problems (DRPs ( related to prescriptions for pediatric outpatients.

Methods: We conducted a randomized controlled trial. We recruited and randomly assigned 31 physicians to control or intervention groups. We collected 775 prescriptions (375 from the control group and 400 from the intervention group) at the start. For 3 weeks, intervention physicians received additional information and meetings with pharmacists in addition to the usual practices of the hospital. We then collected prescriptions at the end of the study. We classified DRPs, based on reliable references (Supplemental Table S1) at baseline and endpoint (a week after the intervention). The primary outcome was the proportion of prescriptions with DRPs, and secondary outcomes were the proportions of prescriptions with specific DRP types.

Results: The influence of the intervention on general DRPs and specific DRPs was the study's main finding. The pharmacist-led intervention helped reduce the prescriptions with DRPs proportion in the intervention group to 41.0%, compared with 49.3% in the control group (p < 0.05). The DRPs proportion related to the timing of administration relative to meals, unlike the other DRP types, increased in the control group (from 31.7% to 34.9%) and decreased in the intervention group (from 31.3% to 25.3%), with a significant difference between the 2 groups at endpoint (p < 0.01). Patients aged >2 to ≤6 years (OR, 1.871; 95% CI, 1.340-2.613) and receiving ≥5 drugs (OR, 5.037; 95% CI, 2.472-10.261) were at greater risk of experiencing DRPs related to prescribing.

Conclusions: A pharmacist-led intervention improved DRP occurrence related to physicians' prescribing. Pharmacists could be involved in in-depth research with physicians in the prescribing process to provide tailored interventions.

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在一个发展中国家，药剂师主导的干预措施减少儿科门诊患者处方中的药物相关问题:一项随机对照试验。

目的:评价药师主导的干预措施在减少儿科门诊处方药物相关问题(DRPs)方面的效果。方法:采用随机对照试验。我们招募并随机分配了31名医生作为对照组或干预组。我们在开始时收集了775张处方(对照组375张，干预组400张)。在3周的时间里，除了医院的常规做法外，干预医生还接受了额外的信息，并与药剂师会面。然后我们在研究结束时收集处方。我们根据基线和终点(干预后一周)的可靠参考资料(补充表S1)对drp进行分类。主要结局指标为含DRP处方的比例，次要结局指标为含特定DRP类型处方的比例。结果:干预对一般DRPs和特异性DRPs的影响是本研究的主要发现。药师主导的干预使干预组处方中DRPs比例降至41.0%，对照组为49.3% (p < 0.05)。与其他DRP类型不同，与给药时间相关的DRP比例在对照组中增加(从31.7%增加到34.9%)，在干预组中减少(从31.3%减少到25.3%)，两组在终点时差异有统计学意义(p < 0.01)。年龄>2 ~≤6岁的患者(OR, 1.871;95% CI, 1.340-2.613)且接受≥5种药物(OR, 5.037;95% CI, 2.472-10.261)与处方相关的drp风险更高。结论:药剂师主导的干预改善了与医生处方相关的DRP发生。药剂师可以在处方过程中与医生进行深入研究，以提供量身定制的干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Pediatric Pharmacology and Therapeutics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

2.40

自引率

0.00%

发文量

期刊介绍： The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.