Kassem Amira B, Al Meslamani Ahmad Z, Elmaghraby Dina H, Magdy Yosr, AbdElrahman Mohamed, Hamdan Ahmed M E, Mohamed Moustafa Hebatallah Ahmed
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt.
College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.
J Pharm Policy Pract. 2024 Jul 12;17(1):2372040. doi: 10.1080/20523211.2024.2372040. eCollection 2024.
Healthcare systems in developing countries faced significant challenges during COVID-19, grappling with limited resources and staffing shortages. Assessment of the impact of pharmaceutical care expertise, particularly in critical care units during the pandemics, in developing countries remains poorly explored. The principal aim of our study was to assess the impact of the Drug and Therapeutics Committee (DTC), comprising clinical pharmacists, on the incidence, types, and severity of medication errors and associated costs in using COVID-19 medications, especially antibiotics.
An interventional pre-post study was carried out at a public isolation hospital in Egypt over 6 months.
Out of 499 medication orders, 238 (47.7%) had medication errors, averaging 2.38 errors per patient. The most frequent were prescribing errors (44.9%), specifically incorrect drug choice (57.9%), excessive dosage (29.9%), treatment duplication (4.5%), inadequate dosage (4.5%), and overlooked indications (3.6%). Linezolid and Remdesivir were the most common medications associated with prescribing errors. Pharmacists intervened 315 times, primarily discontinuing medications, reducing doses, introducing new medications, and increasing doses. These actions led to statistically significant cost reductions ( < 0.05) and better clinical outcomes; improved oxygen saturation, decreased fever, stabilised respiratory rates, and normalised white blood cell counts. So, clinical pharmacist interventions made a notable clinical and economic difference (66.34% reduction of the expenses) in antibiotics usage specifically and other medications used in COVID-19 management during the pandemic.
Crucially, educational initiatives targeting clinical pharmacists can foster judicious prescribing habits.
在新冠疫情期间,发展中国家的医疗系统面临重大挑战,资源有限且人员短缺。在发展中国家,药物治疗专业知识的影响评估,尤其是在疫情期间重症监护病房中的影响评估,仍未得到充分探索。我们研究的主要目的是评估由临床药师组成的药物与治疗学委员会(DTC)对新冠药物(尤其是抗生素)用药错误的发生率、类型、严重程度以及相关成本的影响。
在埃及一家公立隔离医院进行了一项为期6个月的干预前后对照研究。
在499份用药医嘱中,238份(47.7%)存在用药错误,平均每位患者有2.38个错误。最常见的是处方错误(44.9%),具体包括药物选择错误(57.9%)、剂量过大(29.9%)、重复用药(4.5%)、剂量不足(4.5%)以及适应证遗漏(3.6%)。利奈唑胺和瑞德西韦是与处方错误关联最常见的药物。药师进行了315次干预,主要是停用药物、减少剂量、引入新药和增加剂量。这些措施使成本在统计学上显著降低(<0.05),并带来了更好的临床结果;改善了血氧饱和度、降低了发热、稳定了呼吸频率并使白细胞计数恢复正常。因此,临床药师的干预在疫情期间新冠治疗中使用的抗生素及其他药物方面产生了显著的临床和经济差异(费用降低66.34%)。
至关重要的是,针对临床药师的教育举措可以培养明智的处方习惯。