KHẢO SÁT CÁC VẤN ĐỀ LIÊN QUAN ĐẾN THUỐC TRÊN BỆNH NHÂN ĐIỀU TRỊ NGOẠI TRÚ TẠI MỘT BỆNH VIỆN ĐA KHOA THUỘC THÀNH PHỐ THỦ ĐỨC

Abstract

Background: Drug-related problems (DRPs) are common in outpatients, which can reduce the effectiveness and safety of treatment. Therefore, identification of DRPs in outpatients’ prescriptions and DRP related factors is necessary to optimize the treatment. Objectives: To determine the frequency, types of DRPs in outpatients’ prescriptions and factors related to the occurence of DRPs. Materials and methods: A cross-sectional study was conducted on the outpatients’ prescriptions at a provincial general hospital in Thu Duc city, from November 1^st, 2021, to November 15^th, 2021. DRPs were determined by comparing prescriptions to following references: Summary of product characteristics, Vietnamese National Drug Formulary 2018, Diagnostic and Treatment Guidelines of the Ministry of Health, Uptodate, and eMC. DRPs are categorized using Pharmaceutical Care Network Europe (PCNE) version 9.1. Factors associated with the occurence of DRPs were determined using multivariate logistic regression model. Results: There were 5773 prescriptions included in the study (the median age of the patients was 60 (50 - 67), 54% female). The rate of prescriptions with at least 1 DRP was 66.9%. DRPs types were inappropriate medication selection (6.7%), inappropriate dosage (29.8%), dosage frequency (24.0%) and inappropriate timing of administration (26.8%). Patients with ≥ 3 comorbidities, indicated ≥ 5 medications had a higher risk of DRP than those with fewer comorbidities or using fewer drugs (OR = 1.358, CI:1.201– 1.536, p < 0.001; OR =3.814, CI:3.133 – 4.641, p < 0.001, respectively). Prescriptions of endocrinology clinic were less likely to occur DRP (OR=0.736, CI:0.628 – 0.862, p < 0.001), and prescriptions of general internal clinic were at a higher risk of DRP than those of cardiology clinic (OR=2.068, CI:1.782 – 2.400, p < 0.001). Male physician's prescriptions related to an increased risk of DRP compared to female physician's prescriptions (OR =1.330, CI:1.178 – 1.503, p < 0.001). We have not found the association between patient’s age or gender, physician's degree and the occurrence of DRP. Conclusions: About two-thirds of outpatients’ prescriptions had at least 1 DRP. Appropriate interventions, especially on prescriptions of patients with multiple diseases or with polypharmacy, are needed to improve DRPs.