Journal of Research in Pharmacy Practice

Drug‑related problems in medical wards of Tikur Anbessa specialized hospital, Ethiopia

Document Type : Original Article

Authors

. Mohammed Biset Ayalew 1
. Teshome Nedi Megersa 2
. Yewondwossen Taddese Mengistu 3

1 Department of Clinical Pharmacy, College of Medicine and Health Sciences, Gondar University, Gondar, Ethiopia

2 Department of Pharmacology and Clinical Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

3 Department of Internal Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

Abstract
Objective: This study was aimed to determine the prevalence of drug‑related 
problems (DRPs), identify the most common drugs, and drug classes involved in DRPs as 
well as associated factors with the occurrence of DRPs.
Methods: A prospective cross‑sectional study was conducted on 225 patients admitted to 
medical wards of Tikur Anbessa Specialized Hospital, Addis Ababa from March to June 2014. Data 
regarding patient characteristics, medications, diagnosis, length of hospitalization, investigation, 
and laboratory results were collected using data abstraction forms through review of patients’ 
medical card and medication charts. Identified DRPs were recorded and classified using DRP 
registration forms. The possible intervention measures for the identified DRPs were proposed 
and communicated to either the physician or the patient. Data were entered into Epi Info 
7 and analyzed using SPSS version 21 (IBM Corp. Released 2012, Armonk, NY: IBM Corp).
Findings: DRPs were found in 52% of study subjects. A drug‑drug interaction (48% of all DRPs) 
was the most common DRP followed by adverse drug reaction (23%). Anti‑infectives and 
gastrointestinal medicines were commonly involved in DRPs. Drugs with the highest drug 
risk ratio were gentamycin, warfarin, nifedipine, and cimetidine. The number of drugs taken 
by the patient per day is an important risk factor for DRPs.
Conclusion: DRPs are common among medical ward patients. Polypharmacy has a significant 
association with the occurrence of DRP. Drugs such as gentamycin, warfarin, nifedipine, and 
cimetidine have the highest probability of causing DRP. So, patients who are taking either 
of these drugs or polypharmacy should be closely assessed for identification and timely 
correction of DRPs.

Keywords

Drug‑related problem
medical wards
polypharmacy
Tikur Anbessa  specialized hospital

1. Fita R, Syed A, Dewa P, Wasilah R. Involvement of Ward 
Pharmacist During Theraputic Process in Hospitalized 
Geriatric Patients in Dr. Sarjito Hospital, Yogyakarta, 
Indonesia; 2008. Available from: http://www.academia.
edu/3579827. [Last cited on 2014 Nov 09].
2. Classification for Drug Related Problems V 6.20. Pharmaceutical 
Care Network Europe Foundation; c2003‑2010. [About 1 
screen]. Available from: http://www.pcne.org/upload/files/11_
PCNE_classification_V6‑2.pdf. [Last updated on 2010 Jan 14; 
Last cited on 2014 Feb 10].
3. Cipolle R, Strand L, Morley P. Pharmaceutical Care Practice: 
The Clinicians Guide. 2nd ed. New York: McGraw Hill; 2004.
4. Satish K, Prasanna D, Rajesh V, Prashant C. Assessment of 
clinical pharmacist intervention in tertiary care teaching 
hospital of southern India. Asian J Pharm Clin Res 2013;6:258‑61.
5. Kohl L, Corrigan J, Donaldson M, editors. To Err is Human: 
Building a Safer Health System. Washington: National 
Academy Press; 2003. Available from: http://www.books.nap.
edu/html/to_err_is_human/exec_summ.html. [Last cited on 
2014 Feb 12].
6. Ernst FR, Grizzle AJ. Drug‑related morbidity and mortality: 
Updating the cost‑of‑illness model. JAm Pharm Assoc (Wash) 
2001;41:192‑9.
7. Seattle Alliance Outreach. Available from: http://www.
ethiomedic.com/index.php/healthcare‑facilities.[Last updated 
on 2014 Jan 15; Last cited on 2014 Feb 16].
8. Koh Y, Kutty FB, Li SC. Drug‑related problems in hospitalized 
patients on polypharmacy: The influence of age and gender. 
Ther Clin Risk Manag 2005;1:39‑48.
9. Chan DC, Chen JH, Kuo HK, We CJ, Lu IS, Chiu LS, et al.
Drug‑related problems (DRPs) identified from geriatric 
medication safety review clinics. Arch Gerontol Geriatr 
2012;54:168‑74.
10. Tigabu BM, Daba D, Habte B. Drug‑related problems 
among medical ward patients in Jimma university 
specialized hospital, Southwest Ethiopia. J Res Pharm Pract 
2014;3:1‑5.
11. Zaman Huri H, Fun Wee H. Drug related problems in 
type 2 diabetes patients with hypertension: A cross‑sectional 
retrospective study. BMC Endocr Disord 2013;13:2.
12. SomersA, Robays H, De Paepe P, Van Maele G, Perehudoff K, 
PetrovicM. Evaluation of clinical pharmacist recommendations 
in the geriatric ward of a Belgian university hospital. Clin 
Interv Aging 2013;8:703‑9.
13. Al‑Hajje AH, Atoui F, Awada S, Rachidi S, Zein S, Salameh P. 
Drug‑related problems identified by clinical pharmacist’s 
students and pharmacist’s interventions. Ann Pharm Fr 
2012;70:169‑76.
14. Abbasinazari M, Hajhossein TalasazA, EshraghiA, Sahraei Z. 
Detection and management of medication errors in internal 
wards of a teaching hospital by clinical pharmacists. Acta Med 
Iran 2013;51:482‑6.
15. Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, 
LawthersAG, et al. Incidence of adverse events and negligence 
in hospitalized patients. Results of the Harvard Medical 
Practice Study I. N Engl J Med 1991;324:370‑6.
16. Mekonnen AB, Yesuf EA, Odegard PS, Wega SS. 
Implementing ward based clinical pharmacy services in 
an Ethiopian University Hospital. Pharm Pract (Granada) 
2013;11:51‑7.
17. Viktil KK, Blix HS, Moger TA, Reikvam A. Polypharmacy 
as commonly defined is an indicator of limited value in the 
assessment of drug‑related problems. Br J Clin Pharmacol 
2007;63:187‑95.
18. Strand LM, Morley PC, Cipolle RJ, Ramsey R, Lamsam GD. 
Drug‑related problems: Their structure and function. DICP 
1990;24:1093‑7.
19. Blix HS, Viktil KK, Reikvam A, Moger TA, Hjemaas BJ, 
Pretsch P, et al. The majority of hospitalised patients have 
drug‑related problems: Results from a prospective study in 
general hospitals. Eur J Clin Pharmacol 2004;60:651‑8.
20. Aburuz SM, Bulatova NR, Yousef AM, Al‑Ghazawi MA, 
Alawwa IA, Al‑Saleh A. Comprehensive assessment of 
treatment related problems in hospitalized medicine patients 
in Jordan. Int J Clin Pharm 2011;33:501‑11.
21. Nickel CH, Ruedinger JM, Messmer AS, Maile S, Peng A, 
Bodmer M, et al. Drug‑related emergency department visits 
by elderly patients presenting with non‑specific complaints. 
Scand J Trauma Resusc Emerg Med 2013;21:15.
22. Nascimento Y, Carvalho W, Acurcio F. Drug related problems 
observed in a pharmaceutical care service, Belo Horizonte, 
Brazil. Braz J Pharm Sci 2009;45:321‑30
Journal of Research in Pharmacy Practice
Volume 4, Issue 4
Autumn 2015
Pages 216-221

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