Incidence, causes, and management cost of drug related problems in hospitalized patients at Loengnoktha Crown Prince Hospital

Abstract

Drug related problems (DRPs) are important issues among organization, country, and national level. Detecting and solving DRPs are important procedures to reach patient safety goal, which can be achieved by collaboration of healthcare team including physician, pharmacist and nurse. Pharmacists play important role to detect and propose solution to eliminate drug related problems. This study aimed to determine incidence of drug related problems, causes, types of drug related problems, and cost to manage drug related problems. This study was a cross sectional study. All patients admitted to two wards at Loengnoktha Crown Prince Hospital were observed, monitored and detected for DRPs. Type of DRPs were categorized by Hepler and Strand’s DRPs classification algorithm, while severity of DRPs were categorized by Hartwig and Schneider’s criteria. The result from this study showed that there were 98 DRPs identified from 6,262 patients. The incidence of DRPs among hospitalized patient during 10 month period at Loengnoktha Crown Prince Hospital was 1.56%. The most frequently DRPs found was drug-drug interaction (32.7%), followed by improper drug selection (17.3%), subtherapeutic dosage (14.3%).It was found that 54.1% of DRPs were in category B (error did not reach patient), 25.5% were in category A (potential to cause error) and 12.3% were in category E (cause temporary harm, patient need treatment or intervention). When analyzed causes of DRPs, it was found that some of them were a result of system error e.g. information technology did not reach all hospital systems inclusively, the interchange of physicians among hospitals in province. while some of them were human error e.g. personal attitude of patients and doctors. Cost to manage DRPs were calculated using hospital perspective and included only direct medical costs e.g. wages of physicians, nurses and pharmacists, cost of drug and cost of laboratory test. In this study cost to manage 98 DRPs was 18,688.85 Baht.