rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2022-10-07rpcardio-2821Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯAssessment of Drug Related Problems and Pharmacist Interventions in Inpatients with Cardiovascular DiseaseРоль клинического фармаколога в мониторинге нарушений медикаментозного лечения у госпитализированных пациентов с сердечно-сосудистыми заболеваниямиhttps://orcid.org/0000-0001-9186-4231БирадарС. М.BiradarS. M.

 Сиддаруда М. Бирадар

 Виджаяпур 

 Siddaruda M. Biradar 

 Vijayapur 

https://orcid.org/0000-0003-1839-8363КохимаБ.KohimaB.

 Кохима Бонту

 Виджаяпур 

 Kohima Bonthu

 Vijayapur 

https://orcid.org/0000-0003-0611-4861НаякВ.NayakV.

 Вишванат Наяк 

 Виджаяпур 

 Vishwanath Nayak 

 Vijayapur 

https://orcid.org/0000-0002-6100-2929НандиколС.NandikolS.

 Сунанда Нандикол 

 Виджаяпур 

 Sunanda Nandikol 

 Vijayapur 

https://orcid.org/0000-0001-8655-2209ВарадВ.WaradV.

 Виджайкумар Варад

 Виджаяпур 

 Vijaykumar Warad

 Vijayapur 

https://orcid.org/0000-0001-5901-7331БьякодС. М.ByakodS. M.

 Шаранабасаппа М. Бякод

 Виджаяпур 

 Sharanabasappa M. Byakod 

 Vijayapur 

https://orcid.org/0000-0002-9172-3882ХунасагиБ. С.HunasagiB. S.

 Басаварадж С. Хунасаги 

 Виджаяпур 

 Basavaraj S. Hunasagi 

 Vijayapur 

https://orcid.org/0000-0002-7791-2214АвастхиС. Р.AwasthiS. R.

 Сантош Р. Авасти

 Виджаяпур 

 Santhosh R. Awasthi 

 Vijayapur 

 

Фармацевтический и исследовательский центр SSM; Больница и исследовательский центр Медицинского колледжа Шри Б.М. ПатилаИндияSSM College of Pharmacy and Research Centre; Shri B.M. Patil Medical College Hospital and Research CentreIndiaФармацевтический и исследовательский центр SSMИндияSSM College of Pharmacy and Research CentreIndiaБольница и исследовательский центр Медицинского колледжа Шри Б.М. ПатилаИндияShri B.M. Patil Medical College Hospital and Research CentreIndia202203112022185536543Copyright © Biradar S.M., Kohima B., Nayak V., Nandikol S., Warad V., Byakod S.M., Hunasagi B.S., Awasthi S.R., 20222022Бирадар С.М., Кохима Б., Наяк В., Нандикол С., Варад В., Бьякод С.М., Хунасаги Б.С., Авастхи С.Р.Biradar S.M., Kohima B., Nayak V., Nandikol S., Warad V., Byakod S.M., Hunasagi B.S., Awasthi S.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2821

Aim. To identify and evaluate the nature and incidence of drug-related problems (DRPs) and to manifest the role of a pharmacist in ensuring safe and efficient use of medications with cardiovascular disease patients by using PCNE Classification to assess and report drug-related problems.Material and Methods. An Observational and Prospective study was conducted in a tertiary care hospital of medicine department of general and intensive/critical care units for a period of 6 months to identify and evaluate the nature and incidence of DRP’s and to manifest the role of a pharmacist in ensuring safe and efficient use of medications with cardiovascular disease patients by using PCNE Classification to assess and report drug-related problems.Results. Of 94 Patient profiles were evaluated out of which 78 (82.9%) patient profiles were identified with 208 DRPs. Among 208, 140 (67.3%) drug interactions, 15 (7.2%) untreated indication, 12 (5.8%) adverse drug reactions, 10 (4.8%) drug use without indication, 8 (3.8%) drug underused, 8 (3.8%) duration of treatment too short, 5 (2.4%) dose unclear, 4 (1.9%) inappropriate drug form, 3 (1.4%) duration of treatment too long, 2 (1.0%) too many drugs prescribed for an indication, 1 (0.5%) drug overused. For 208 DRPs identified and provided with 74 interventions which includes 30 (41.6%) drug discontinuation, 24 (33.3%) addition of a new drug, 4 (5.55%) change of dosage form, and 14 (19.4%) decrease the dose.Conclusion. The present study revealed that patients with cardiovascular diseases suffer from numerous DRPs that can be identified, resolved, or prevented to some extent by pharmacist intervention. Hence the study addresses the importance of clinical pharmacist in the management of DRPs among cardiovascular patients.

Цель. Выявить и оценить характер и частоту нарушений медикаментозного лечения (НМЛ), а также продемонстрировать роль клинического фармаколога в обеспечении безопасного и эффективного использования лекарств у госпитализированных пациентов с сердечно-сосудистыми заболеваниями с применением классификации PCNE для оценки и сообщения о НМЛ.Материал и методы. Обсервационное проспективное исследование было проведено в клинической больнице третичного уровня в отделении общей и интенсивной терапии в течение 6 мес для выявления и оценки характера и частоты НМЛ и демонстрации роли клинического фармаколога в обеспечении безопасного и эффективного использования лекарственных препаратов (ЛП) у пациентов с сердечно-сосудистыми заболеваниями с использованием классификации PCNE для оценки и сообщения о НМЛ.Результаты. Были оценены 94 пациента с сердечно-сосудистыми заболеваниями, из которых у 78 (82,9%) были зарегистрированы 208 НМЛ. Из 208 было выявлено 140 (67,3%) случаев межлекарственных взаимодействий, 15 (7,2%) – неназначения ЛП при наличии показаний, 12 (5,8%) – нежелательных лекарственных реакций, 10 (4,8%) – назначения ЛП без показаний, 8 (3,8%) – применения ЛП в недостаточной терапевтической дозе, 8 (3,8%) – недостаточной продолжительности лечения, 5 (2,4%) – лечения неуточненными дозами ЛП, 4 (1,9%) – использования неподходящей лекарственной формы, 3 (1,4%) – слишком длительного лечения, 2 (1,0%) – полипрагмазии, 1 (0,5%) – злоупотребления лекарственными препаратами. Для 208 НМЛ было проведено 74 вмешательства клинического фармаколога, в том числе 30 (41,6%) отмен ЛП, 24 (33,3%) добавления нового ЛП, 4 (5,55%) изменения лекарственной формы и 14 (19,4%) снижений дозы ЛП.Заключение. Настоящее исследование показало, что пациенты с сердечно-сосудистыми заболеваниями имеют многочисленные НМЛ, которые могут быть выявлены, устранены или в некоторой степени предотвращены вмешательством клинического фармаколога. Следовательно, в исследовании рассматривается важность клинического фармаколога в коррекции НМЛ у госпитализированных пациентов с сердечно-сосудистыми заболеваниями.

сердечно-сосудистые заболеваниянарушения медикаментозной терапииклинический фармакологфармакотерапияcardiovascular diseasesdrug therapy problemspharmacist interventionpharmaceutical careИсследование проведено при поддержке Фармацевтического и исследовательского центра SSM (Виджаяпур, Индия) и Больницы и исследовательского центра Медицинского колледжа Шри Б.М. Патила (Виджаяпур, Индия).The study was performed with the support of the SSM College of Pharmacy and Research Centre and Shri B.M. Patil Medical College Hospital and Research Centre.ReferencesJavedh S, Sandeep B, Shastry CS. Assessment of Drug Related Problems in Patients with Cardiovascular Diseases in a Tertiary Care Teaching Hospital. J Pharm Care. 2014;2(2):70-6.Javedh S, Sandeep B, Shastry CS. Assessment of Drug Related Problems in Patients with Cardiovascular Diseases in a Tertiary Care Teaching Hospital. J Pharm Care. 2014;2(2):70-6.PCNE Classification V8.01,2017-6-15 [cited 2021 Jan 10]. Available from: https://www.pcne.org/upload/files/215_PCNE_classification_V8-01.pdf.PCNE Classification V8.01,2017-6-15 [cited 2021 Jan 10]. Available from: https://www.pcne.org/upload/files/215_PCNE_classification_V8-01.pdf.Wincent MM, Potrilingam D, Anagha V. Assessment of Drug Related Problems in patients with Chronic diseases in the general medicine units of a tertiary care hospital. Int J Pharm Pharm Sci. 2017;9(12):194-200. DOI:10.22159/ijpps.2017v9i12.21660.Wincent MM, Potrilingam D, Anagha V. Assessment of Drug Related Problems in patients with Chronic diseases in the general medicine units of a tertiary care hospital. Int J Pharm Pharm Sci. 2017;9(12):194-200. DOI:10.22159/ijpps.2017v9i12.21660.Sharma A, Baldi A, Sharma D. Assessment of drug related problems among Diabetes and Cardiovascular disease patients in a tertiary care teaching hospital. Pharm Aspire. 2018;10(1):7-12. DOI:10.4314/tjpr.v15i10.29.Sharma A, Baldi A, Sharma D. Assessment of drug related problems among Diabetes and Cardiovascular disease patients in a tertiary care teaching hospital. Pharm Aspire. 2018;10(1):7-12. DOI:10.4314/tjpr.v15i10.29.Gashaw B, Mequanent K, Masho T. Assessment of Drug Related Problems and its Associated Factors among Medical Ward Patients in University of Gondar Teaching Hospital, Northwest Ethiopia: A Prospective Cross-Sectional Study. J Basic Clin Pharma. 2017;8(S1):S16-S21.Gashaw B, Mequanent K, Masho T. Assessment of Drug Related Problems and its Associated Factors among Medical Ward Patients in University of Gondar Teaching Hospital, Northwest Ethiopia: A Prospective Cross-Sectional Study. J Basic Clin Pharma. 2017;8(S1):S16-S21.Gobezie T, Belay Y, Elias Ali Y, et al. Drug Therapy Problems among patients with Cardiovascular Diseases in Felege Hiwot Referral Hospital North East Ethiopia. International Journal of Pharmacy Teaching and Practices. 2014;5(5):989-96. DOI:10.22270/jddt.v9i2-s.2439.Gobezie T, Belay Y, Elias Ali Y, et al. Drug Therapy Problems among patients with Cardiovascular Diseases in Felege Hiwot Referral Hospital North East Ethiopia. International Journal of Pharmacy Teaching and Practices. 2014;5(5):989-96. DOI:10.22270/jddt.v9i2-s.2439.Tegegne G, Yimam B, Yesuf E. Drug Therapy Problem among patients with Cardiovascular Disease in Felege Hiwot Referral Hospital. Int J Pharm Teach Pract. 2014;5(3):989-96.Tegegne G, Yimam B, Yesuf E. Drug Therapy Problem among patients with Cardiovascular Disease in Felege Hiwot Referral Hospital. Int J Pharm Teach Pract. 2014;5(3):989-96.Gizaw K, Dubale M. Drug Related Problems and Contributing Factors among Adult Ambulatory Patients with Cardiovascular Disease at Gebretsadik Shawogeneral hospital. Journal of Natural Sciences Research. 2017;7(1):2224-3186.Gizaw K, Dubale M. Drug Related Problems and Contributing Factors among Adult Ambulatory Patients with Cardiovascular Disease at Gebretsadik Shawogeneral hospital. Journal of Natural Sciences Research. 2017;7(1):2224-3186.Chauhan S, Aeri B. Prevalence of Cardiovascular disease in India and its economic impact. Int J Sci Res Publ. 2013;3(10):2250-3153.Chauhan S, Aeri B. Prevalence of Cardiovascular disease in India and its economic impact. Int J Sci Res Publ. 2013;3(10):2250-3153.Dorairaj P, Panniyammakal J, Ambuj R. Cardiovascular disease in India Current epidemiology and future directions. Circulation. 2016;1(1):1605-20. DOI:10.1161/CIRCULATIONAHA.114.008729.Dorairaj P, Panniyammakal J, Ambuj R. Cardiovascular disease in India Current epidemiology and future directions. Circulation. 2016;1(1):1605-20. DOI:10.1161/CIRCULATIONAHA.114.008729.Soumya S, Ramakrishna P, Vidya S, et al. Pattern of pharmacotherapy and assessment of drug related problems in Ischemic Heart Disease patients. Int Res J Pharma. 2019;10(3):136-43. DOI:10.7897/2230-8407.100392.Soumya S, Ramakrishna P, Vidya S, et al. Pattern of pharmacotherapy and assessment of drug related problems in Ischemic Heart Disease patients. Int Res J Pharma. 2019;10(3):136-43. DOI:10.7897/2230-8407.100392.Rani RA. Drug Related Problems And Reactive Pharmacist Interventions for Inpatients Receiving Cardiovascular Drugs. IJBMSP. 2013;3(2):42-8.Rani RA. Drug Related Problems And Reactive Pharmacist Interventions for Inpatients Receiving Cardiovascular Drugs. IJBMSP. 2013;3(2):42-8.Olatz U, Olivia F, Sonia L, et al. Patient risk factors for developing a drug related problem in a cardiology ward. Ther Clin Risk Manag. 2015;11:9-15. DOI:10.2147/TCRM.S71749.Olatz U, Olivia F, Sonia L, et al. Patient risk factors for developing a drug related problem in a cardiology ward. Ther Clin Risk Manag. 2015;11:9-15. DOI:10.2147/TCRM.S71749.Laika G, Arijana M, Bilgen B. Pharmacist intervention in drug related problems for patients with cardiovascular disease in selected community pharmacies in Northern Cyprus. Trop J Pharm Res. 2016;15(10):2275-81. DOI:10.4314/tjpr.v15i10.29.Laika G, Arijana M, Bilgen B. Pharmacist intervention in drug related problems for patients with cardiovascular disease in selected community pharmacies in Northern Cyprus. Trop J Pharm Res. 2016;15(10):2275-81. DOI:10.4314/tjpr.v15i10.29.Murray M, Ritchey M, Wu J, et al. Effect of a pharmacist on Adverse Drug Events and Medication Errors in Outpatients with Cardiovascular Disease. Arch Intern Med. 2009;169(8):757-63. DOI:10.1001/archinternmed.2009.59.Murray M, Ritchey M, Wu J, et al. Effect of a pharmacist on Adverse Drug Events and Medication Errors in Outpatients with Cardiovascular Disease. Arch Intern Med. 2009;169(8):757-63. DOI:10.1001/archinternmed.2009.59.Sai Hamsini L, Priyanka G, Chandralekha D, et al. A study to assess drug related problems in patients with Cardiovascular Diseases in a tertiary care teaching hospital. J Drug Del Ther. 2019;9(2):20-7. DOI:10.22270/jddt.v9i2-s.2439.Sai Hamsini L, Priyanka G, Chandralekha D, et al. A study to assess drug related problems in patients with Cardiovascular Diseases in a tertiary care teaching hospital. J Drug Del Ther. 2019;9(2):20-7. DOI:10.22270/jddt.v9i2-s.2439.Prajapati A, Shrikalp D. Drug Therapy Management of Cardiovascular Disease patients admitted to Intensive Care Units of Tertiary Care Hospitals. Indian J Pharm Prac. 2015;8(1):13-8. DOI:10.5530/ijopp.8.1.4.Prajapati A, Shrikalp D. Drug Therapy Management of Cardiovascular Disease patients admitted to Intensive Care Units of Tertiary Care Hospitals. Indian J Pharm Prac. 2015;8(1):13-8. DOI:10.5530/ijopp.8.1.4.Sushil G, Ramesh G, Kumar G, et al. Emerging risk factors for disease: Indian context. Indian J Endocrinol Metab. 2013;17(5):806-14. DOI:10.4103/2230-8210.117212.Sushil G, Ramesh G, Kumar G, et al. Emerging risk factors for disease: Indian context. Indian J Endocrinol Metab. 2013;17(5):806-14. DOI:10.4103/2230-8210.117212.Bela S, Prashant M. Surveillance of Cardiovascular disease risk factors in India: The need and scope. Indian J Med Res. 2013;132(5):634-42. DOI:10.4103/0971-5916.73420.Bela S, Prashant M. Surveillance of Cardiovascular disease risk factors in India: The need and scope. Indian J Med Res. 2013;132(5):634-42. DOI:10.4103/0971-5916.73420.Devarashetty V, Praveen A, Manjunath R. Potential Drug-Drug interaction among Ischemic Heart Disease patients at a tertiary care hospital. Natl J Physiol Pharm Pharmacol. 2020;10(7):557-62. DOI:10.5455/njppp.2020.10.12389201926042020.Devarashetty V, Praveen A, Manjunath R. Potential Drug-Drug interaction among Ischemic Heart Disease patients at a tertiary care hospital. Natl J Physiol Pharm Pharmacol. 2020;10(7):557-62. DOI:10.5455/njppp.2020.10.12389201926042020.Yaschilal M, Belanyeh G, Amberbir A. A prospective observational study of drug therapy problems in medical ward of a referral hospital in northeast Ethiopia. BMC Heath Services Research. 2018;18(1):808. DOI:10.1186/s12913-018-3612-x.Yaschilal M, Belanyeh G, Amberbir A. A prospective observational study of drug therapy problems in medical ward of a referral hospital in northeast Ethiopia. BMC Heath Services Research. 2018;18(1):808. DOI:10.1186/s12913-018-3612-x.Punniyakotti S, Nimisha. A retrospective observational study on Drug Related Problems in patients with Rheumatic Heart Disease. Int J Res Pharma Sci. 2018;10(1):135-9. DOI:10.26452/ijrps.v10i1.1789.Punniyakotti S, Nimisha. A retrospective observational study on Drug Related Problems in patients with Rheumatic Heart Disease. Int J Res Pharma Sci. 2018;10(1):135-9. DOI:10.26452/ijrps.v10i1.1789.Yirga L, Kabaye K, Tesfaye D. Drug Therapy Problems and contributing factors in the management of Heart Failure patients in Jimma University specialised hospital Southwest Ethiopia. PLoS One. 2018;13(10):e0206120. DOI:10.1371/journal.pone.0206120.Yirga L, Kabaye K, Tesfaye D. Drug Therapy Problems and contributing factors in the management of Heart Failure patients in Jimma University specialised hospital Southwest Ethiopia. PLoS One. 2018;13(10):e0206120. DOI:10.1371/journal.pone.0206120.Omboni S, Caserini M. Effectiveness of Pharmacist’s intervention in the management of cardiovascular disease. Open Heart. 2018;5(1):e000687. DOI:10.1136/openhrt-2017-000687.Omboni S, Caserini M. Effectiveness of Pharmacist’s intervention in the management of cardiovascular disease. Open Heart. 2018;5(1):e000687. DOI:10.1136/openhrt-2017-000687.

The authors declare that there are no conflicts of interest present.