Assessment of Drug Related Problems in Tertiary Care Hospital

Abstract

Aims: Drug-related problems (DRPs) are common in hospitalized patients due to polypharmacy and complex therapeutic regimens, often leading to preventable morbidity. Their proper use improves quality of life, prevents complications, and enhances clinical outcomes. Study Design: Prospective observational study Place and Duration of Study: General Medicine and Surgery departments of a tertiary care teaching hospital, conducted over nine months (June 2020–March 2021). Methodology: Inpatients aged 18–60 years with chronic conditions and receiving more than three allopathic medications were recruited after consent to enroll in the study. Data on demographics, ICD-11-coded diagnoses and prescriptions were gathered daily from admission to discharge through patient and caregiver interview along with reviewing case record. Drug-related problems (DRPs) were identified and classified using Hepler and Strand’s system. A convenience sampling technique was employed, DRP prevalence was calculated as the proportion of prescriptions with at least one DRP and descriptive statistics were used for analysis. Results: A total of 1,238 inpatients were enrolled, with a higher proportion of males (58%) and a mean age of 56.4 years. Most participants were from the General Medicine department (51%), Circulatory disorders (24.6%) and endocrine/metabolic issues (18.4%) were predominated. Overall, 599 DRPs occurred in 48.38% of cases, led by drug-drug interactions (39.4%), such as hydrocortisone-furosemide and aspirin-metformin pairs, followed by adverse drug reactions (26.7%), including diarrhea and hypoglycemia. Other issues included untreated indications (8.35%), overdosing (7.18%), and drug use without indication (8.18%). Conclusion: This study demonstrates a high prevalence of drug-related problems among inpatients, with drug–drug interactions and ADRs being the most common. The need for stronger medication monitoring practices, implementing clinical pharmacy services and routine drug utilization reviews can significantly enhance patient safety in tertiary care hospitals.