Balan Shamala, Mohan Kavidha, Liang Vanitha Hong Wee, Ghazali Hanis Hazwanie, Suan Chew Li, Chee Chong Chia, En Kong Wei, Makhdzir Leana Fatimah, Samsuri Nurul Syafiqah, Tamyes Nor Mazni Mohamad, Lim Juliana Nazlim, Azami Nur Amirah Mohd Noor, Samad Suhaili, Singh Kiren Kaur Chut, Khan Nurfareeza Nazir, Chamati Siti Hajar, Hassan Nurdiana, Ping Kuay Hue, Nordin Farraha, Hoong Lau Wai, Bakar Azlen Awatif Abu
Pharmacy Department, Hospital Tengku Ampuan Rahimah, Klang, Selangor, Malaysia.
Pharmacy Department, Hospital Selayang, Selayang, Selangor, Malaysia.
Sci Rep. 2025 Sep 30;15(1):33852. doi: 10.1038/s41598-025-06061-2.
Pharmacists' counselling roles expanded significantly during the COVID-19 pandemic, yet drug-related problems (DRPs) and challenges during nirmatrelvir/ritonavir counselling remain underreported. The study aimed to characterise the DRPs and challenges encountered during nirmatrelvir/ritonavir counselling by pharmacists in the central region of Malaysia. A cross-sectional study was conducted in government hospitals and primary care clinics involving patients who received nirmatrelvir/ritonavir counselling from July to September 2022. The DRPs were adapted from a classification system for intermediate and long-term care settings. Descriptive analysis was conducted using SPSS version 20. The study included 3,626 patients, aged 18 to 99 years (54.56 ± 17.66). Overall, 2,371 (65.39%) patients had at least one DRP. A total of 3,687 DRPs were identified across 22 types, primarily for drug-drug interactions (n = 2,158, 58.53%), and adverse drug reactions (ADR) (n = 1,019, 27.64%). A total of 1,988 patients (54.83%) had at least one pre-existing drug interacting with nirmatrelvir/ritonavir. About 6.45% (n = 234) of patients discontinued nirmatrelvir/ritonavir, with 2.18% due to ADR. Overall, 2,775 challenges encountered during nirmatrelvir/ritonavir counselling were recorded, mainly involving communication medium barrier (n = 1,446, 52.11%) and inability to contact patients (n = 1,164, 41.95%). The study highlighted prevalent DRPs and challenges in nirmatrelvir/ritonavir counselling, emphasising personalised management and infrastructure improvements for optimal COVID-19 treatment.
