Analysis of drug-related problems in ischemic stroke in-patients in one Indonesian district hospital

Pub Date : 2024-04-01 DOI:10.46542/pe.2024.242.134139
R. Andrajati, L. A. Kusumawardani, Isti Nurul Afifah, H. W. Risni
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Abstract

Background: Ischemic stroke is one of the leading causes of death in Indonesia. Appropriate management, including the identification of drug-related problems (DRPs), is needed to prevent disability and death.     Objective: This study aimed to analyse DRPs as defined by the Pharmaceutical Care Network Europe (PCNE).      Method: This was a cross-sectional research using the medical records of in-patients with ischemic stroke aged >18 years.     Result: Out of the 115 patients examined, 51.3% were male, and the mean age was 57.85 + 10.539 years. Exactly 204 cases of DRPs and 175 causes appeared in 101 patients. A total of 58 patients experienced one-to-two problems, and 43 patients experienced more than two problems. The problems domain consists of therapeutic effectiveness (P1, 133(65.2%)), adverse effects (P2, 67(32, 84%)), and medical expenses (P3, 4(1, 96%)). The DRPs mostly involved antihypertension and antiplatelet. The most common cause was a new indication for treatment (C1.9, 51(29.14%)) and drug interactions (C8.1, 48(27.43%)). Multivariate analysis of patient characteristics showed that patients taking more than eight medications were more likely to experience more than two DRPs than those on one-to-four medications (OR 5.593; 95%, CI 1.015-30.812).     Conclusion: Most patients experienced one-to-two DRPs with the highest being a potentially suboptimal treatment. Clinical pharmacists are expected to monitor therapy, especially in polypharmacy patients.
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印度尼西亚一家地区医院缺血性中风住院病人的药物相关问题分析
背景:缺血性中风是印度尼西亚的主要死亡原因之一。需要进行适当的管理,包括识别与药物相关的问题(DRPs),以预防残疾和死亡。 研究目的本研究旨在分析欧洲药品护理网络(PCNE)定义的 DRP。 研究方法这是一项横断面研究,使用的是年龄大于 18 岁的缺血性中风住院患者的医疗记录。 研究结果在接受检查的 115 名患者中,51.3% 为男性,平均年龄为 57.85 + 10.539 岁。101名患者中出现了204例DRP和175个病因。共有 58 名患者出现一至两个问题,43 名患者出现两个以上问题。问题领域包括治疗效果(P1,133(65.2%))、不良反应(P2,67(32,84%))和医疗费用(P3,4(1,96%))。DRP 大多涉及抗高血压和抗血小板。最常见的原因是新的治疗适应症(C1.9,51(29.14%))和药物相互作用(C8.1,48(27.43%))。对患者特征的多变量分析表明,与服用一至四种药物的患者相比,服用八种以上药物的患者更有可能出现两次以上的 DRP(OR 5.593;95%,CI 1.015-30.812)。 结论大多数患者的 DRP 为一至两次,最高的一次可能是次优治疗。临床药剂师应该对治疗进行监控,尤其是对使用多种药物的患者。
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