Implementation and Evaluation of Clinical Pharmacy Services on Improving Quality of Prescribing in Geriatric Inpatients in Vietnam: An Example in a Low-Resources Setting
- PMID: 35903286
- PMCID: PMC9314755
- DOI: 10.2147/CIA.S368871
Implementation and Evaluation of Clinical Pharmacy Services on Improving Quality of Prescribing in Geriatric Inpatients in Vietnam: An Example in a Low-Resources Setting
Abstract
Purpose: Geriatric inpatients generally have a high risk of drug-related problems (DRP) in prescribing following hospital admission, which are likely to cause negative clinical consequences. This is particularly evident in developing countries such as Vietnam. Therefore, clinical pharmacy service (CPS) aims to identify and resolve these DRPs to improve the quality use of medicines in the older population following hospital admission.
Patients and methods: The study was conducted as a prospective, single-center study implemented at a general public hospital in Hanoi. Patients aged ≥60 years with at least three chronic diseases admitted to the Internal Medicine Department between August 2020 and December 2020 were eligible to be enrolled. A well-trained clinical pharmacist provided a structured CPS to identify any DRP in prescribing for each patient in the study. Clinical pharmacist interventions were then proposed to the attending physicians and documented in the DRP reporting system.
Results: A total of 255 DRP were identified in 185 patients during the study period. The most frequent types of DRP were underuse (21.2%), dose too high (12.2%), and contraindication (11.8%). There was a very high rate of approval and uptake by the physicians regarding the interventions proposed by the clinical pharmacist (82.4% fully accepted and 12.5% partially accepted). Of the interventions, 73.4% were clinically relevant (pADE score ≥0.1). In general, 9 out of 10 physicians agreed that CPS has significant benefits for both patients and physicians.
Conclusion: Improving clinical pharmacy services can potentially have a positive impact on the quality of prescribing in elderly inpatients. These services should officially be implemented to optimize the quality use of medicines in this population group in Vietnam.
Keywords: geriatrics; pharmacy practice; quality use of medicine.
© 2022 Dong et al.
Conflict of interest statement
The authors declare that they have no competing interests.
Figures
Similar articles
-
Drug related problems and pharmacist interventions in a geriatric unit employing electronic prescribing.Int J Clin Pharm. 2013 Oct;35(5):847-53. doi: 10.1007/s11096-013-9821-9. Epub 2013 Jul 16. Int J Clin Pharm. 2013. PMID: 23857430
-
Evaluation of the implementation of a clinical pharmacy service on an acute internal medicine ward in Italy.BMC Health Serv Res. 2018 Apr 10;18(1):259. doi: 10.1186/s12913-018-2988-y. BMC Health Serv Res. 2018. PMID: 29631587 Free PMC article.
-
The effect of an active on-ward participation of hospital pharmacists in Internal Medicine teams on preventable Adverse Drug Events in elderly inpatients: protocol of the WINGS study (Ward-oriented pharmacy in newly admitted geriatric seniors).BMC Health Serv Res. 2011 May 25;11:124. doi: 10.1186/1472-6963-11-124. BMC Health Serv Res. 2011. PMID: 21612624 Free PMC article.
-
Economic impact of clinical pharmaceutical activities in hospital wards: A systematic review.Res Social Adm Pharm. 2021 Mar;17(3):497-505. doi: 10.1016/j.sapharm.2020.07.016. Epub 2020 Jul 30. Res Social Adm Pharm. 2021. PMID: 32819880
-
[Medication safety in hospitals : Integration of clinical pharmacists to reduce drug-related problems in the inpatient setting].Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018 Sep;61(9):1103-1110. doi: 10.1007/s00103-018-2788-x. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2018. PMID: 30022237 Review. German.
Cited by
-
Translation and validation of the CLEO tool in Vietnamese to assess the significance of pharmacist interventions.Int J Clin Pharm. 2025 Feb;47(1):119-127. doi: 10.1007/s11096-024-01813-y. Epub 2024 Oct 4. Int J Clin Pharm. 2025. PMID: 39365523
-
The Impact of Insulin Staging in the Context of Pharmaceutical Care on Patients with Type 2 Diabetes Mellitus.Diabetes Metab Syndr Obes. 2023 Jan 11;16:71-83. doi: 10.2147/DMSO.S388750. eCollection 2023. Diabetes Metab Syndr Obes. 2023. PMID: 36760575 Free PMC article. Clinical Trial.
-
A Clinical Pharmacist-led Approach on Reducing Drug Related Problems Among Patients with Neurological Disorders: An Interventional Study.Explor Res Clin Soc Pharm. 2023 Jul 8;11:100302. doi: 10.1016/j.rcsop.2023.100302. eCollection 2023 Sep. Explor Res Clin Soc Pharm. 2023. PMID: 37538991 Free PMC article.
-
Building Medication Profiles in the Elderly: a Qualitative Study Based on Medication Information Literacy in a Long-Term Care Facility.Clin Interv Aging. 2024 May 11;19:779-793. doi: 10.2147/CIA.S454620. eCollection 2024. Clin Interv Aging. 2024. PMID: 38751855 Free PMC article.
-
Clinical impact of an individualised clinical pharmacy programme into the memory care pathway of older people: an observational study.Int J Clin Pharm. 2024 Aug;46(4):889-898. doi: 10.1007/s11096-024-01723-z. Epub 2024 Apr 20. Int J Clin Pharm. 2024. PMID: 38642248
References
-
- Steinman MA, Landefeld CS, Rosenthal GE, Berthenthal D, Sen S, Kaboli PJ. Polypharmacy and prescribing quality in older people. J Am Geriatr Soc. 2006;54(10):1516–1523. - PubMed
-
- Belda-Rustarazo S, Cantero-Hinojosa J, Salmeron-Garcia A, Gonzalez-Garcia L, Cabeza-Barrera J, Galvez J. Medication reconciliation at admission and discharge: an analysis of prevalence and associated risk factors. Int J Clin Pract. 2015;69(11):1268–1274. - PubMed
-
- Rodriguez Vargas B, Delgado Silveira E, Iglesias Peinado I, Bermejo Vicedo T. Prevalence and risk factors for medication reconciliation errors during hospital admission in elderly patients. Int J Clin Pharm. 2016;38(5):1164–1171. - PubMed
MeSH terms
LinkOut - more resources
Full Text Sources
Medical