Clinical Pharmacist’s Role in Optimizing Therapy through Drug-Related Problems Identification

Abstract

Clinical pharmacists play an important role in a clinical setting as part of a team. Drug-related problem (DRP) is the main part pharmacist should focus on to achieve the optimal therapy for patients. Therefore, this study aimed to investigate the role of clinical pharmacy in a private hospital of West Java, Indonesia, and describe the prevalence of DRPs and several factors associated with the risk of DRPs. The clinical pharmacist's monthly report was obtained from June to August 2020. Furthermore, problems, causes, and types of DRP were identified using PCNE Classification V9.1. Drug classes and other factors related to DRP were also investigated. This was a descriptive study with a retrospective approach to medical records, where 240 DRPs were identified in 157 patients. Approximately 4.45% experienced DRP, especially in ICU at 45.83% and Stroke Unit or SU-IC at 25.42%. The most common DRPs were incomplete drug treatment, drug interaction, and dose adjustment. Antimicrobial, cardiovascular agents, and PPI were the most commonly involved. In the linear regression analysis, length of stay and number of therapy significantly affect DRP. In this study, pharmacists intervented each DRP, with 57% accepted as fully and partially implemented by the physicians. A total of 22% of interventions ended with unknown status due to limited follow-up time. Meanwhile, reviews on medication by clinical pharmacists lead to improvement in drug treatment. The implementation of clinical pharmacy services shows many DRPs to be prevented and increases therapy optimization.