Clinical pharmacist interventions in managing drug-related problems in hospitalized patients with neurological diseases.

Background Drug-related problems (DRPs) are common in hospitalized patients with neurological diseases. Clinical pharmacy services could minimize drug-related harm and improve patient care. Objective To identify common DRPs in neurology and document clinical pharmacists' medication-related interventions. Setting The wards and intensive care unit of the Department of Neurology at Assiut University Hospital. Method Prospective study of clinical pharmacists' interventions during the routine care work of reviewing patients medical charts over a period of 6 months from January to June 2017. Main outcome measure The frequency and severity of DRPs and clinical pharmacists' recommendations. Results Out of 1421 reviewed medications charts, a total of 414 DRPs were detected for 285 admitted patients. The most common DRPs were drug selection problems (36.7%) and dosing errors (27.5%). The majority of DRPs (71.7%) were categorized as causing no patient harm. Clinical pharmacists provided recommendations for the detected problems that ranged from drug monitoring to stop and starting new medicines. About 90% of pharmacists' interventions were accepted by physicians. Poisson regression of factors that may influence the frequency of DRPs revealed significant associations of patient age (p = 0.03) and the number of comorbid diseases (p = 0.01). Conclusions Prescribing errors in neurology inpatient are likely to occur. Clinical pharmacists' interventions assisted in early detection of drug problems and prevention of the consequent patient harms.