DETECTION OF DRUG-RELATED PROBLEMS IN ANTIMICROBIALS

Objective: The purpose of this study is to analyze drug-related problems (DRP) and pharmaceutical interventions being perfromed regarding antimicrobial therapy in a county hospital, as well as the results of such interventions on the patient. Method: We collected prospective information of all pharmaceutical interventions performed and the detected drug-related problems in antibiotic treatment for patients of a 360-bed county hospital for a 6-month period. The DRP were catalogued according to the Granada consensus' classification and ranked by severity type. For every detected DRP we performed an intervention and reported whether the proposal was accepted or rejected by the physician, as well as the adequacy of such action and results on the patient. Results: During the period of study, we detected 83 DPR that produced 83 interventions. According to the DRP classification based on the Granada consensus, among all the detected DRP, 13 were related to the indication, 31 to effectiveness and 39 to safety. The most frequently identified DRPs were linked to dosage: too high dose (40%) and too low dose (35%). Among the detected DRP 55 had reached the patient (real error), while 28 were potential errors. Of all the performed interventions (n = 83), 62 were accepted (74.7%), while 15 were rejected (18.1%). The remaining 6 were of unknown result. Conclusions: The dedication of a pharmacist to the hospitalized patient pharmacotherapeutic follow-up with the purpose of preventing, identifying and resolving DRP that may interfere in achieving positive therapeutic results produces a qualitative improvement in the overall care process. In order to optimize the pharmaceutical care process, some improvements could be made to the system such as integrating the pharmacist in a multidisciplinary team and implementing an electronic prescription system.