Drug-related problems identified in the medication follow-up of patients hospitalized in a university hospital
DOI:
https://doi.org/10.30968/jhphs.2025.164.1360Abstract
Objective: To analyze the drug-related problems (DRPs) identified from the medication follow-up (MF) performed by pharmacy residents on hospitalized patients at a university hospital. Methods: A descriptive cross-sectional study was conducted between August and December 2024 at a high-complexity university hospital in the city of Rio de Janeiro. Data was obtained from the MF of patients in the medical and geriatric clinics, performed by pharmacy residents between January 2022 and December 2023. The identified DPRs were recorded on a specific MF form. Subsequently, they were compiled in an online Google Drive spreadsheet and coded according to the method of the French Society of Clinical Pharmacy. MF forms containing at least one identified DRP were included in the study, and those with errors in completion that compromised the final analysis were excluded. The drugs were coded according to the first level (main anatomical group) and fifth level (chemical substance) of the Anatomical Therapeutic Chemical (ATC) code. Descriptive statistical analysis of the data was performed in an online Google Drive spreadsheet. Results: Of the 469 patients monitored during this period, 183 had at least one DRP identified. A total of 339 DRPs were identified, at an average rate of 1.8 per patient, and were targeted for intervention in the AF. Following pharmaceutical intervention, 61.9% of DRPs were resolved. The main DRP was ‘untreated indication’ (45.1%), followed by ‘inappropriate administration’ (18.9%) and ‘overdose’ (14.7%). In terms of the ATC code, the majority of drugs belonged to the ‘gastrointestinal tract and metabolism’ group (30.4%), with omeprazole being the main representative (18.4%). The second most frequent group was ‘nervous system’ (19.5%), mainly represented by dipyrone (27.3%), followed by the ‘blood and haematopoietic organs’ group (17.4%), mainly represented by enoxaparin (50.8%). Conclusions: The data showed that AF is capable of identifying DRPs during hospitalisation, highlighting the contribution of pharmacists to the rational use of medication. The presented data may assist with institutional strategies aimed at DRPs at higher risk. Finally, it is suggested that studies evaluating the clinical outcomes of identified PRMs are conducted.
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