Identification of Medication Related Problems (MRPs) at Pediatric Intensive Care Unit in Public Sector Hospital: Role of clinical Pharmacist in Rational Prescribing

Pediatric pharmaceutical care is a highly challenging aspect and needs a great deal of knowledge and concern in decision making. In developing countries, the medication related problems are significant because healthcare facilities are in primitive state with respect to trained and qualified staff, resources allocation, availability, and affordability of medicines. The current study was conducted to detect and analyze medication-related problems (MRPs) and the role of clinical pharmacists in the Pediatric Intensive Care Unit (PICU) in improving the quality of pharmacotherapy and patient safety. A prospective study for a period of 6 months in a tertiary care public sector hospital was conducted and the sample size was composed of N=100. The study period was from July 2019 to December 2019. During the study, all MRPs, including adverse drug reactions, drug interactions, and the clinical pharmacist's interventions, were recorded. Naranjo causality assessment algorithm used for categorizing suspected ADRs. Of the 100 patients recorded, 312 MRPs were identified that were further categorized into medication error (77.24%), adverse drug reactions (10.25%), and drug interactions (12.5%). 241 interventions were made and accepted on an average of 2.41 interventions per patient. The most frequent interventions were made for the wrong selection of drugs (19.55%) and 36.21% for inappropriate doses. The acceptance rate of clinical pharmacist intervention was 81.01% analyzed by linear regression. The Naranjo causality assessment showed that most of the ADRs were probable (72.41%) and 3 of them were precise (10.34%); causality was mainly attributed to antibacterial and antiepileptic drugs. In conclusion, the present findings emphasized the involvement of clinical pharmacists as part of a multidisciplinary healthcare team for the safe and appropriate usage of medicines that will ultimately improve the standards of pharmacotherapy and patient safety.