Identification and resolution of drug-related problems among neonates in neonatal intensive care unit (NICU): A prospective longitudinal observational study

Abstract

Background: Drug related problems (DRPs) can interfere with the desired therapeutic outcomes. Neonates are susceptible for DRP occurrence due to clinical heterogeneity, inappropriate formulations, complexity of drug regimens and polypharmacy. Thus, the objective of this study was to characterize the DRP, their resolutions and associated risk factors among neonates in the Neonatal Intensive Care Unit (NICU). Methods: A cross-sectional study was carried out in NICU ward at tertiary care teaching hospital for 18 months. Clinical pharmacists participated on daily basis to collect patient information and assess their medication therapy for DRPs. DRPs were classified into problems and their causes according to Pharmaceutical Care Network Europe (PCNE) Version 9.1. Clinical pharmacist implicated evidence-based interventions to resolve DRPs. SPSS V.25 was used for the statistical analysis. Univariate logistic regression analysis was used for the determination of risk factors for DRPs, with a p-value <0.05 for associations that were statistically significant. Results: A total of 426 neonates were enrolled with a mean gestational age of 35.2 ± 7.5 weeks and a mean birth weight of 2316 ± 1814 g. A total of 486 DRPs were found among 55.6 % neonates. Among them, majority of DRPs were belongs to treatment effectiveness [n = 427 (87.8 %)]. In total, 559 interventions were made, resulting in the resolution of 87.4 % of the DRPs. Furthermore, neonates staying in hospital for more than 5 days identified as most significant risk factor of DRPs. Conclusion: DRPs are common in neonates admitted to NICU. Clinical Pharmacist can play significant roles in identifying, preventing and resolving DRPs among neonates.

Keywords

• Neonates
• Neonatal intensive care unit (NICU)
• Drug related problem
• Pharmaceutical care network europe
• Clinical pharmacist interventions