(226) Determination of Predictors of Drug Related Problems Associated with Narrow Therapeutic Index Drugs

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1271

Presenting Author(s)

Ramesh Madhan, PhD
– Professor, JSS College of Pharmacy, Mysore, India

Co-Author(s)

Charmi Chhatrala
– JSS College of Pharmacy, Mysuru, India
Bhanu Kumar M
– JSS Academy of Higher Education and Research, Mysuru, India
Chalasani Sri Harsha, MPharm
– JSS College of Pharmacy, Dept of Pharmacy Practice, JSS College of Pharmacy, Mysuru, Karnataka, India
Jehath M. Syed
– JSS College of Pharmacy, Mysuru, Karnataka, India

Background: Narrow therapeutic index drugs (NTIDs) are vulnerable to cause frequent drug related problems (DRPs), which can result in patient harm and increased healthcare costs. Identification of risk factors associated with DRP occurrence may help in prevention of the same.

Objectives: To determine predictors of drug related problems associated with the use of narrow therapeutic index drugs.

Methods: A prospective study was conducted in the department of general medicine, cardiology, neurology and paediatrics at tertiary teaching care hospital. Patients of all the age group and who received at least one NTID were enrolled in the study with their consent. The list of NTIDs was prepared through literature review. Hepler and Strand classification system was adapted to identify and classify DRPs. A logistic regression model was used to calculate the odds ratio of predictors for occurrence of DRPs at 95% confidence interval and statistical significance at P< 0.05.

Results: A total of 180 DRPs were identified amongst 63 [(78.75%) (n=80)] patients wherein, 58 [72.5%] were males and 22 [27.5%] were females. Most frequently recorded DRPs were drug-drug interactions 99 [55%], followed by Sub-therapeutic dosing [36 (20%)], ADRs [20 (11.11%)], Untreated indication [1 (0.56%)] & Improper drug selection [2 (1.11%)]. Average of DRPs found was 2.85 per patient. The independent risk factors for DRPs found were increased age [OR 0.3455 (0.1361- 0.5253), p= 0.0017], increased number of co-morbidities [OR 0.2858 (0.0705- 0.4756), p= 0.0102], increased number of NTIDs used [OR 0.2720 (0.0556- 0.4640), p= 0.0147] and increased length of hospital stay [OR 0.2260 (0.0066- 0.4246), p= 0.0438].

Conclusions: Following the interim analysis, these results indicate that ageing, number of comorbidities, number of NTIDs used and length of hospital stay are clinically significant yet statistically not. The analysis will be continued till the project completes. Clinical pharmacist assists in early detection of DRPs and improving overall patient safety.