Takele Bereket, Koyra Hailu Chare, Sidamo Temesgen, Lerango Temesgen Leka
School of Pharmacy, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia.
Front Pharmacol. 2024 Apr 25;15:1375728. doi: 10.3389/fphar.2024.1375728. eCollection 2024.
A drug therapy problem (DTP) is any undesirable event experienced by a patient that accompanies drug therapy, prevents the patient from achieving their desired therapeutic goals, and requires expert judgment to resolve. Pediatric populations are at a higher risk of DTP than adults due to their immature organ systems, including the liver and kidneys, which play crucial roles in drug metabolism and excretion. Most previous studies have focused on only one element of DTP. Therefore, by considering all elements of DTP, we aimed to assess the prevalence of DTP and associated factors among pediatric patients admitted to the Wolaita Sodo University Comprehensive Specialized Hospital.
An institution-based cross-sectional study was conducted among pediatric patients admitted to Wolaita Sodo University Comprehensive Specialized Hospital from 8 July 2020, to 7 July 2021. A simple random sampling technique was employed to select study participants. Cipolle's and Strand's classification method of drug therapy problems was used to identify and categorize DTP. Data were obtained by reviewing the patient's medical records using a data abstraction checklist, entered into Epi data version 4.6, and exported to SPSS version 25 for analysis. Binary logistic regression analysis was performed to identify independent predictors of DTP.
Medical records of 369 pediatric patients were reviewed, and the overall prevalence of DTP was 60.2% (95% CI:55.2%, 65.2%) with a total of 281 identified DTPs. Among them, 164 (74.2%) had only one DTP. Need additional drug therapy was the most common (140 [49.8%]) DTP identified. The number of disease conditions (AOR = 2.13, 95% CI:1.16, 3.92), polypharmacy (AOR = 3.01, 95% CI:1.70, 5.32), and duration of hospital stay (AOR = 1.80, 95% CI:1.04, 3.10) were independent predictors of DTP among admitted pediatric patients.
The prevalence of DTP in pediatric patients in the current setting was high. The number of disease conditions, polypharmacy, and duration of hospital stay were independent predictors of DTP. Enhancements to pharmaceutical care services, optimized dosage practices, improved deprescribing by clinicians, and efficient, comprehensive diagnostic procedures have the potential to significantly reduce specific drug therapy problems in hospitalized pediatrics.
药物治疗问题（DTP）是指患者在药物治疗过程中经历的任何不良事件，它阻碍患者实现其期望的治疗目标，并且需要专家判断来解决。由于儿童的器官系统，包括在药物代谢和排泄中起关键作用的肝脏和肾脏尚未发育成熟，因此儿童群体比成人面临更高的DTP风险。以往的大多数研究仅关注DTP的一个方面。因此，通过考虑DTP的所有方面，我们旨在评估沃莱塔索多大学综合专科医院收治的儿科患者中DTP的患病率及相关因素。
对2020年7月8日至2021年7月7日在沃莱塔索多大学综合专科医院住院的儿科患者进行了一项基于机构的横断面研究。采用简单随机抽样技术选择研究参与者。使用Cipolle和Strand的药物治疗问题分类方法来识别和分类DTP。通过使用数据提取清单查阅患者的病历获取数据，将其录入Epi data 4.6版本，并导出到SPSS 25版本进行分析。进行二元逻辑回归分析以确定DTP的独立预测因素。
回顾了369名儿科患者的病历，DTP的总体患病率为60.2%（95%CI：55.2%，65.2%），共识别出281个DTP。其中，164例（74.2%）仅有一个DTP。需要额外的药物治疗是最常见的（140例[49.8%]）已识别的DTP。疾病状况数量（AOR = 2.13，95%CI：1.16，3.92）、联合用药（AOR = 3.01，95%CI：1.70，5.32）和住院时间（AOR = 1.80，95%CI：1.04，3.10）是住院儿科患者中DTP的独立预测因素。
在当前环境下，儿科患者中DTP的患病率较高。疾病状况数量、联合用药和住院时间是DTP的独立预测因素。加强药学服务、优化给药方法、临床医生改进撤药措施以及高效、全面的诊断程序有可能显著减少住院儿科患者中特定的药物治疗问题。
