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Impact of pharmacist interventions on drug-related problems in general surgery patients: a randomised controlled trial
  1. Salah AbuRuz1,2,
  2. Deema Jaber3,
  3. Iman Basheti4,
  4. Aya Sadeq5,
  5. Mosab Arafat5,
  6. Mohammad AlAhmad5,
  7. Amira Said5
  1. 1Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
  2. 2Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
  3. 3Department of Clinical Pharmacy, School of Pharmacy, Zarqa University, Zarqa, Amman, Jordan
  4. 4Department of Clinical Pharmacy and Therapeutics, Applied Science University, Amman, Jordan
  5. 5College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, United Arab Emirates
  1. Correspondence to Professor Salah AbuRuz, Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates; saburuz{at}uaeu.ac.ae

Abstract

Objectives The inappropriate use of medications is harmful and is a common issue in hospitalised patients. Patients hospitalised in general surgery wards are usually at high risk for drug-related problems (DRPs). This randomised controlled trial aimed to explore the value of a pharmaceutical care service conducted in general surgery wards in the identification and reduction of DRPs in comparison with standard medical care.

Methods This study was conducted in general surgery wards including abdominal, cardiovascular, vascular, endocrine, orthopaedic and oncological surgeries at one of the largest teaching hospitals in Jordan over a period of 6 months. Recruited patients were randomised into intervention or control groups. Clinical pharmacists assessed patients’ DRPs and submitted recommendations to resolve the identified DRPs in the intervention group.

Results Patients in the intervention group (n=63) and the control group (n=60) had a mean age of 55±14.4 years, with 52.0% being women. A total of 1062 DRPs were identified, with a mean of 8.6±3.6 per patient (intervention group, 8.65±4.2; control group, 8.62±2.6; p=0.56). The commonly identified DRPs included safety (20.2%) and efficacy (19.0%) issues. The acceptance rate for pharmacists’ recommendations by physicians was very high (90%) with a good DRP correction rate of 58.9% during patients’ hospital stay. The value of pharmaceutical care was significantly reflected in the achievement of the therapeutic outcomes and prevention of morbidity (resolved/improved or prevented) of 68.2% (24.2%+44%) in the intervention group compared with 19.2% (12.4%+6.8%) in the control group (p<0.001).

Conclusions This study shows that DRPs are common among general surgery patients in Jordan, especially those related to drug safety and efficacy. Pharmacists’ recommendations contributed substantially to resolving most of the identified DRPs and had a significant impact on improving medications used in general surgery patients.

  • clinical pharmacy
  • evidence based medicine
  • medical errors
  • public health
  • surgery
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