Clinical pharmacists' interventions about drug therapy problems and its acceptability by prescribers among pediatric hospitalized patients with infectious diseases in resource-limited settings.

Background: Infectious disease continues to be a major cause of death among pediatrics. Drug therapy problem (DTP) is a significant public health challenge that is highly prevalent in pediatrics, and it has an impact on the effectiveness and safety of drug therapy to a greater extent than in adults. Thus, this study aimed to determine the magnitude of DTPs, types and acceptability of pharmaceutical interventions by prescribers and its associated factors among hospitalized pediatric patients with infectious diseases at pediatric wards of Public comprehensive specialized hospitals (PCSHs).

Methods: This multicenter crosssectional study was conducted among pediatric patients with infectious disease admitted to PCSH pediatric wards from December 01, 2023, to February 30, 2024. Cipolle's and Strand's DTP classification methods were used for the identification of DTPs. Pharmaceutical interventions and their acceptance rate by prescribers were classified according to the Pharmaceutical Care Network Europe (PCNE) 2019. Data was entered and analyzed into SPSS version 27. To identify predictors of DTP occurrence, multivariable logistic regression analysis was used. A pvalue of less than 0.05 was considered statistically significant.

Results: A total of 389 pediatric patients were involved in the current study, selected from an initial sample size of 405, resulting in a response rate of 96.05%. The overall prevalence of DTPs was 56.56% which occurred in 220 pediatric hospitalized patients with infectious disease. The most commonly encountered type of pharmaceutical intervention provided was adjusting the dose of medication (25.2%), followed by patient education/counseling/adherence (23.2%), and discontinuation of medications (20.54%). The acceptance level of interventions by prescribers was high (84.0%). Medication non-compliance (43.6%), unnecessary drug therapy (16.0%), and dose too high (12.0%) were common types of DTPs. Patients with the prolonged hospital stay (6-10 days) [AOR = 2.02, 95%CI: 1.33-7.80] and more than ten days in hospital [AOR = 2.89, 95%CI: 1.90-11.23]; patients with high number of medications (≥ 5) [AOR = 4.60, 95%CI: 1.89-8.82]; those who paid for their medications [AOR = 2.19, 95%CI: 1.18, 3.31], and patients with comorbidity [AOR = 3.90, 95% CI: 1.56-8.15] were the predictors of the occurrence of DTPs.

Conclusion: This study finding revealed that the magnitude of DTPs was high in pediatric inpatients with infectious diseases at PCSHs. The presence of comorbidity, source of medication fee, polypharmacy, and prolonged hospital stays were factors associated with the occurrence of DTPs. The acceptance rate of interventions by the prescribers was high. Clinical pharmacists' involvement in direct patient care responsibility astutely reduces drug therapy problems and hence increases patient safety.