Objective: To highlight
the role and responsibilities of a Clinical Pharmacist in disease and drug
therapy management at a tertiary care hospital.
Background:
With recent advancements in drug therapy management and increasing volume of
new information continuously pouring in areas of pharmaceutical formulations,
pharmacokinetics, dosing, pharmacodynamics, adverse effects, drug interactions,
patient compliance, pharmacogenomics and pharmacoeconomics, new challenges are
being posed to the healthcare personnel for optimizing clinical outcomes of
pharmacotherapeutics among patients. With this very objective this paper
presents observations, interventions and outcomes of a clinical pharmacist led
initiatives in a few wards of a tertiary care hospital during the course of his
routine practical training work and highlights the benefits that such services
can yield to the patients by way of assistance offered to the other partners of
healthcare system.
Methodology: The
study was carried out in four different wards of a tertiary care hospital over a period of
four months. A total of 12 cases were selected out of which 3 were from
Cardiology, 3 from General Medicine 2 from Gastroenterology and 4 from Accident
and Emergency wards. Data was collected from patient record files by examining
the patients' demographic data, past medical and medication history, laboratory
investigations. Data was also collected from treatment charts and individual patient
interviews. During the entire period of study, selected cases in the respective
wards were continuously monitored for patients’ drug related needs and problems
and all cases were followed up till their discharge from the hospital.
Results: Present
study revealed that total no. of drugs prescribed to these 12 patients under study were 85 and
average no. of drugs prescribed per patient was 7 out of which most frequently
prescribed therapeutic class of drugs was antibiotics (16), followed by Proton
Pump Inhibitors (12), vitamins and supplements(12), antihypertensive (08), anticoagulants
(5), steroids (4) and others (28). No. of injectables prescribed were 42 out of
a total of 85 drugs. Other parameters like total no. of drug related problems,
patients related needs, no. of patients counselled, no. of drug interactions
identified are discussed in detail.
Conclusion: Hospitalized patients in medicine-related
wards have a wide range of diseases and are frequently prescribed with large
number of drugs which makes drug therapy complex. Therefore Clinical Pharmacy
services can help in monitoring of drug therapy and addressing the patients’
actual drug related needs and problems. This paper underlines the need to
include a clinical pharmacist in daily ward rounds and seek his assistance is
making the best possible pharmacotherapeutic options available to the patients
and thereby minimize unwanted effects and improve his health related quality of
life.
Key Words: Drug therapy
management; Disease management; Clinical Pharmacy Services; Tertiary care
hospitals; Drug related problems; Drug related needs
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