THE ANALYSIS OF DRUG – RELATED PROBLEMS IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE TREATED WITH PROTON-PUMP INHIBITORS
Abstract
Introduction: Drug-related problems are frequent in almost all therapeutic areas.
Aims: The aim of this paper was to detect drug - related problems in patients with gastro-esophageal reflux and to analyze their possible association with the patient characteristics.
Material and methods: The study was designed as descriptive, retrospective, cross-sectional study aiming to determine the most common drug - related problems in patients with gastro-esophageal reflux disease treated with proton-pump inhibitors. The survey was conducted at the Department of Gastroenterology, Clinical Centre in Kragujevac. The study enrolled all patients treated from gastroesophageal reflux disease with proton pump inhibitors during the time period from 1.1.2014 until 1.1.2015. The study used descriptive statistics (percentage distribution, mean and standard deviation). The correlation between the number of adverse events and patient characteristics was also calculated.
Results: The average age of the patients was 55.97 ± 15.811 years, and 43 of the patients (60.6 %) were male. The average hospitalization duration was 12.30 ± 8.89 days. Based on the Pharmaceutical Care Network Europe classification, there were 182 Drug-Related Problems which was, on average, 2.56 problems per patient. Only 5 patients (7%) did not report any problem while 11 patients (15.49%) had over 10 possible drug-drug interactions. The most common problems which occurred were erroneous drug choice, inappropriate administration and possible interactions between medications.
Conclusions: Based on the results of this study, one must pay attention to possible drug-drug interactions and other problems which may occur with proton-pump inhibitors. Recognition of different sub-types of drug-related problems and of factors associated with drug-related problems may reduce risk from adverse outcomes of gastro-esophageal reflux disease treatment with proton pump inhibitors.
References
Sugimoto M, Shirai N, Nishino M, et al. Comparison of acid inhibition with standard dosages of proton pump inhibitors in relation to CYP2C19 genotype in Japanese. Eur J Clin Pharmacol. 2014; 70 (9): 1073-8.
Ratin AC, Orso IR. Minimal endoscopic changes in non-erosive reflux disease. Arq Bras Cir Dig. 2015; 28 (1): 20-3.
Pyun JE, Choi da M, Lee JH, Yoo KH, Shim JO. Achalasia Previously Diagnosed as Gastroesophageal Reflux Disease by Relying on Esophageal Impedance-pH Monitoring: Use of High-Resolution Esophageal Manometry in Children. Pediatr Gastroenterol Hepatol Nutr. 2015; 18 (1): 55-9.
Falk GL, Beattie J, Ing A, et al. Scintigraphy in laryngopharyngeal and gastroesophageal reflux disease: A definitive diagnostic test? World J Gastroenterol. 2015; 21 (12): 3619-27.
Pharmaceutical Care Network Europe Foundation. (2006) PCNE Classification for Drug Related Problems Version 5.01. Available: http://www.pcne.org/sig/ drp/documents/PCNE%20classification%20V5.01.pdf, Accessed 09 July 2014.
Page II RL, Ruscin JM. The risk of adverse drug events and hospital-related morbidity and mortality among older adults with potentially inappropriate medication use. The American Journal of Geriatric Pharmacotherapy 2006; 4 (4): 297–305.
Silva C, Ramalho C, Luz I, Monteiro J, Fresco P. Drug-related problems in institutionalized, polyme-dicated elderly patients: opportunities for pharmacist intervention. Int J Clin Pharm. 2015; 37 (2): 327-34.
Planas LG, Kimberlin CL, Segal R, et al. A pharmacist model of perceived responsibility for drug therapy outcomes. Social Science & Medicine 2005; 60: 2393–403.
Jensen RT. Consequences of long-term proton pump blockade: insights from studies of patients with gastrinomas. Basic Clin Pharmacol Toxicol. 2006; 98 (1): 4-19.
van Roozendaal BW, Krass I. Development of an evidence-based checklist for the detection of drug related problems in type 2 diabetes. Pharmacy World and Science 2009; 31: 580–95.
Zaman Huri H, Hoo FW. Drug related problems in type 2 diabetes patients with hypertension: A cross-sectional retrospective study. BMC Endocrine Disorders 2013; 13 (2): 1-25.
Bjorkman IK, Sanner MA, Bernsten CB. Comparing 4 classification systems for drug-related problems: processes and functions. Res. Soc. Adm. Pharm. 2008; 4: 320–31.
Lampert ML, Kraehenbuehl S, Hug BL. Drug-related problems: evaluation of a classification system in the daily practice of a Swiss University hospital. Pharm World Sci 2008; 30: 768–76.
Van Mil JW, Westerlund LO, Hersberger KE, Schaefer MA. Drug-relatedproblem classification systems. Ann Pharmacother 2004; 38: 859–67.
Zaman Huri H, Hui Xin C, Sulaiman CZ. Drug-Related Problems in Patients with Benign Prostatic Hyper-plasia: A Cross Sectional Retrospective Study. PLoS ONE 2014; 9(1): e86215.
Drug Interaction Checker, Available at: http://reference.medscape.com/drug-interactionchecker
Al-Arifi M, Abu-Hashem H, Al-Meziny M, Said R, Aljadhey H. Emergency department visits and admissions due to drug related problems at Riyadh military hospital (RMH), Saudi Arabia. Saudi Pharm J. 2014; 22 (1): 17-25.
Chan A, Soh D, Ko Y, Huang YC, Chiang J. Characteristics of unplanned hospital admissions due to drug-related problems in cancer patients. Support Care Cancer. 2014; 22 (7): 1875-81.
Urbina O, Ferrández O, Luque S, еt al. Patient risk factors for developing a drug-related problem in a cardiology ward. Ther Clin Risk Manag. 2014; 11: 9-15.
Raimbault-Chupin M, Spiesser-Robelet L, Guir V, et al. Drug related problems and pharmacist interventions in a geriatric unit employing electronic prescribing. Int J Clin Pharm. 2013; 35 (5): 847-53.
Westerlund T, Gelin U, Pettersson E, Skärlund F, Wågström K, Ringbom C. A retrospective analysis of drug-related problems documented in a national database. Int J Clin Pharm. 2013; 35 (2): 202-9.
Willoch K, Blix HS, Pedersen-Bjergaard AM, Eek AK, Reikvam A. Handling drug-related problems in rehabilitation patients: a randomized study. Int J Clin Pharm. 2012; 34 (2): 382-8.