Identification of Drug Related Problems by Clinical Pharmacist in Prescriptions with Polypharmacy: A Prospective Interventional Study

Objectives: Drug Related Problems (DRPs) and prescriptions with polypharmacy may lead to increased health care cost, morbidity, mortality and decreased quality of life. The objective of the study was to assess the pattern of DRPs associated with polypharmacy. Methods: It is a hospital based prospective interventional study carried out for 6 months in the Department of General Medicine. The DRPs were identified by researchers during ward rounds by reviewing the patient case reports. Problems identified and recognized was documented and discussed with the concerned health care team. Results: During the study period, 150 patient case sheets were reviewed to identify 213 DRPs. The most common DRP was found to be Adverse Drug Reactions (ADRs) (45%) followed by needs additional drug therapy (26.8%), untreated indication (13.6%) and Drug-Drug Interactions (DDIs) (11.7%). Binary logistic regression was performed to identify the predictors of DRPs. It was observed that number of comorbidities (Adjusted odds ratio (AOR) = 3.68 (p < 0.001)), geriatric population and polypharmacy were the major predictor. Conclusion: The study highlights the importance of drug therapy review to minimize DRPs, ADRs, polypharmacy, framing of new deprescribing guidelines and algorithms for drugs which are utilized inappropriately, deprescribing of redundant drugs during routine clinical practice and appointment of clinical pharmacist in hospitals to achieve better therapeutic outcomes and improved patient care.