Pharmacist-led interventions to reduce drug-related problems in prescribing for Vietnamese outpatients

Abstract

Drug-related problems (DRPs) can lead to adverse outcomes and increase the risk of hospitalization. Pharmacist interventions can help to reduce these problems. We aimed to evaluate the effect of pharmacist-led interventions on DRPs in prescribing for outpatients and determine the risk factors of these DRPs. We conducted a before-and-after intervention study on prescribing process for outpatients from a hospital in Vietnam. We collected prescriptions from the hospital’s electronic prescription system. Clinical pharmacists determined DRPs following (1) medication leaflets, (2) guidelines of the Vietnam Ministry of Health, (3) Vietnamese National Drug Formulary. We checked drug-drug interactions using Drugs.com. Interventions, including a workshop on DRPs, providing information sheets, and reminding physicians about DRPs, were conducted by researchers in collaboration with clinical pharmacists in the study hospital. In the pre-intervention phase, we analyzed 3352 prescriptions. The number of prescriptions with at least 1 DRP was 88.8%. In the post-intervention, we analyzed 2685 prescriptions. The number of prescriptions with at least 1 DRP decreased from 88.8% to 74.9% (p<0.001). Pharmacist interventions are effective on DRPs in drug indications (p<0.001), dosage (p<0.001), frequency of use (p<0.001), time of taking medications (p<0.001). There was no significant improvement in DRPs of the time of taking drugs compared with meals and drug-drug interaction after interventions. The number of DRP increases with the number of drugs prescribed (p<0.001). In conclusion, pharmacist-led interventions reduced the proportion of prescriptions with DRPs. Prescribing 5 or more medications increased the risk of DRPs occurrence.

Keywords

• drug-related problems
• outpatients
• prescribing
• pharmacist-led interventions