IDENTIFICATION AND EVALUATION OF DRUG RELATED PROBLEMS IN INTENSIVE CARE UNITS AND EMERGENCY WARD OF A TERTIARY CARE TEACHING HOSPITAL

Objective: To identify and assess the drug related problems in Intensive Care Units and Emergency Wards of a tertiary care teaching hospital. Methods: This was a prospective observational study in which all patients above 18 years of age admitted to ICU’s and emergency ward were considered in inclusion criteria. Exclusion criteria involved patients not willing to participate and poisoning related cases. After the initial visit the patients’ case sheets were followed and the collected data was analyzed for possible Drug Related Problems. Results: In this study 160 cases were analyzed for DRPs. In terms of DRP, 146 cases were identified with DRP and 14 cases without DRPs. Major poly-pharmacy was common in the hospitalized patients as 69.4% of patients were given more than 10 drugs during the hospital stay. Drug-Drug interactions (64.47%) were the top ranking DRP followed by Drug Choice Problems (30.19%), Dosing Problems (3.77%) and ADRs (1.57%). The most common class of drugs involved in DRPs was Loop Diuretics. Azithromycin and Ondansetron was the most common drugs that interacted with each other. Potentially inappropriate drugs for geriatrics include Acetaminophen (9), Tramadol (7). Y-site drug incompatibility was 13.9%. There was an association between age, poly-pharmacy, co-morbidities and length of hospital stay with DRPs. Conclusion: Considering the results and conclusions, this study shows the significance of the need for clinical pharmacy services for better management of disease in order to reduce DRPs and improve quality of life.