Department of Pharmacy Practice, Srinivas College of Pharmacy, Valachil, Post Farangipete, Mangalore-574143.
Drugs are essential for curing illnesses and enhancing well-being. However, drug therapy problems (DTPs) might arise as a result of incorrect drug use. Any unwanted event that a patient experiences that requires or is thought to involve drug therapy and that really or potentially interferes with a desired patient result is classified as a DTP by Cipolle/Morley/Strand. The goal of the current investigation, which was a prospective observational study carried out over a 6-month period in a tertiary care hospital, was to determine the prevalence of medication therapy issues and its risk factors among pediatric patients there. Most DTPs deal with prescription, including drug selection, dose, and usage. The prevalence of DTP can result in treatment failure, increase the number of follow-up visits and readmissions, and significantly increase the need for new prescription drugs and treatment costs. In order to lower the risk of potential drug therapy problems, the study's findings emphasize the role clinical pharmacists can play in promoting better medication use and ensuring pediatric patients receive the appropriate medications for their conditions while taking physiologic factors, polypharmacy, etc. into account. 150 people participated in this six-month trial, which was carried out in a tertiary care hospital.
Drugs are essential for curing illnesses and enhancing well-being. However, drug therapy problems (DTPs) might arise as a result of incorrect drug use. Any unwanted event that a patient experiences that requires or is thought to involve drug therapy and that really or potentially interferes with a desired patient result is classified as a DTP by Cipolle/Morley/Strand [2]. By contrasting the suitability of indications, dosage, administration time, and adverse drug reactions with widely accepted guidelines, DTPs can be found (Table 1). One group that is particularly vulnerable to drug-related issues is pediatric patients [1]. DTPs can happen to patients of different ages and demographics. regarding 30 to 40% of pediatric patients have at least one DTP, which has raised serious concerns regarding the occurrence of DTPs in this population [2, 3]. The majority of DTPs have to do with prescribing: drug choice, dosage, and use. DTPs can lead to treatment failure, raise the frequency of follow-up visits and readmissions, and dramatically raise the need for additional prescriptions and treatment expenses [4,5,6]. Compared to adult patients, pediatric inpatients may experience three times as many medication errors, and these mistakes are often detrimental. Additionally, neonates exhibit protracted gastric emptying. Acid-labile medications such as ampicillin and benzyl penicillin are therefore efficiently absorbed during the neonatal period, but phenytoin, phenobarbital, and rifampicin have poor absorption. Furthermore, throughout the first year of life, it is quite usual for stomach contents to reflux retrogradely into the esophagus [7]. Drug therapy issues in pediatric patients can be caused by a variety of factors, including polypharmacy, specific infectious and parasitic diseases, the type of admission, the length of hospital stay, and the number of disease conditions. DTPs have several established risk factors, several of which are evidently related to child therapy. It becomes clear which child populations are more at risk for adverse drug reactions (ADRs) when the type of pediatric medication is taken into account. Children are particularly vulnerable to adverse drug reactions (ADRs) due to a combination of established risk factors and the nature of pediatric pharmacotherapy. [7] A lack of research data on this population, unlicensed pharmaceuticals, pediatric-appropriate dose form-inappropriate goods, improper dosage estimates based on weight and age, and poor communication skills are some of the potential risk factors.[8] Most DRPs deal with prescription, including drug selection, dose, and usage. The prevalence of DRP can result in treatment failure, increase the number of follow-up visits and readmissions, and significantly increase the need for new prescription drugs and treatment costs [9]. It is crucial to identify and classify DRPs in the correct order. to provide appropriate ways to lessen them and achieve the intended outcomes at the most affordable prices. [10]
MATERIALS AND METHODS
Study Design: A Prospective observational study was carried out to identify the disease and drug category which are prevalent with drug therapy problems in paediatric patients.
Sample Size: 150 people made up the study's sample. Sample size was calculated using finite population formula and was based on convenience.
Study Criteria:
Inclusion criteria:
Exclusion Criteria:
Source Of Data Collection
Data collecting forms were used to gather the study's data. The data collected included patient’s demographic details, personal history, medical and medication history, current diagnosis and drug therapy details, and any problems that were observed by the patient during the course of the treatment.
Statistical Analysis:
The collected data was analysed using Microsoft Excel 2019.
RESULT:
Patient Demographics:
The study included 150 pediatric patients, ranging in age from one month to seventeen years. With the use of a patient interview form, each patient's information and medical history were gathered. There were 62 female patients and 88 male patients out of 150. Of the 150 individuals who took part in the study, 16 were prescribed more than five medications, and 142 had only one condition. Table 1 lists the specific demographic characteristics of the patients who took part in this investigation.
Table 1: Demographic features and clinical characterization of the patient
|
Variable |
Category |
Frequency N=150 |
Percentage (%) |
|
Age |
0-1month 1month-1 year 2years-12 years 13years-17years |
1 14 111 24 |
0.67 9.33 74 16 |
|
Gender |
Male Female |
88 62 |
58.67 41.33 |
|
Number Of Drugs Prescribed |
1-4 ? 5 |
134 16 |
89.33 10.67 |
|
Number Of Ailments |
Single ailment Multiple ailment |
142 8 |
94.67 5.33 |
|
Pateint Distribution |
In Patients Out Patients |
78 72 |
52 48 |
Prevalence Of Drug Therapy Problems (DTPS):
It was determined that 116 of the 150 patients who took part in the trial had DTPs. Using the Cipolle/Morley/Strand categorization, 118 DTPs in total were found and categorized.
The prevalence of pediatric patients included in this study with DTPs can be calculated by using the following formula-
Prevalence of pediatric patients with DTPs = (Number of pediatric patients with DTPs / Total number of pediatric patients considered under study) *100.
Figure 1. Patients identified with the presence of DTPs
Among 118 patients identified with DTP’s, 67 male patients (56.78%) and 51 female patients (43.22%) had DTPs which indicates that the prevalence of DTPs in male patients is more than the Female patients.
Figure 2. Prevalence of DTP’s based on gender
In case of age group, prevalence of DTPs among the Pediatric patients was found to have no significant impact. 107 out of 111 patients between 2 to 12 years, 6 out of 24 patients between 13 to 17 years, 5 out of 14 patients between 1 month to 1 year and none between the age group of 0-1 month were identified to have DTPs as shown in Fig 3
Figure 3. Prevalence of DTP’s based on age groups
Risk Factors Contributing Towards Drug Therapy Problems
It was clear from this study that a small number of factors, including polypharmacy and the number of diseases, contributed to the rise in DTPs. The frequency of patients diagnosed with a single ailment might be explained by the fact that 14 out of 16 patients (87.5%) with more than five medications had DTPs, and single sickness was highly related with DTPs.
Table 3: Risk factors and prevalence of DTPs
|
Variables |
Category |
Total no. N = 150 |
Patients identified with DTP’s (n=118) |
Prevalence in terms of percentage (%) |
|
Age |
0-1month |
1 |
0 |
0 |
|
1month-1 year |
14 |
5 |
4.24 |
|
|
2years-12 years |
111 |
107 |
90.68 |
|
|
13years-17years |
24 |
6 |
5.08 |
|
|
Gender |
Male |
88 |
67 |
56.78 |
|
Female |
62 |
51 |
43.22 |
|
|
Number Of Drugs Prescribed |
1-4 |
134 |
104 |
88.14 |
|
? 5 |
16 |
14 |
11.86 |
|
|
Number Of Ailments |
Single ailment |
142 |
114 |
96.61 |
|
Multiple ailment |
8 |
4 |
3.39 |
DISCUSSION:
Problems with drug therapy are turning into a major public health concern. Pediatric patients are particularly vulnerable to DTPs because to a number of factors, including as inadequate prescribing and polypharmacy. Consequently, it is critical to recognize and stop DTPs in this group. There are several reasons why children's drug therapy problems are largely unknown. Out-patients are responsible for acquiring and delivering their own prescription medications, in contrast to in-patients. [1] It has been demonstrated that the occurrence of DTPs in pediatric patients has no appreciable impact on age group. It was discovered that the age group with the highest DTP was two to twelve years old.This study found no appreciable distinction between the frequency of DTPs and the rising number of diseases. Most individuals had only one illness diagnosis and DTPs. Current research suggests that the aforementioned findings may have been caused by the study's sample size. [4]
The recent investigation found that there were more men than women among the patients. Patients younger than six made up about 70% of the participants.[11]Paediatric patients between the ages of 2 and 12 are really believed to be at greater risk for drug therapy difficulties due to variables like developmental changes, variations in drug metabolism, and different reactions to medications. Additionally, studies often suggest that men may experience more problems with pharmaceutical therapy than women, however this may vary according on the drug and the ailment. By constantly monitoring and adjusting medication therapy, these hazards can be decreased in this age range and gender. Similar results were observed by Rashed et al. In order to lower the risk of potential drug therapy problems, the study's findings emphasize the role clinical pharmacists can play in promoting better medication use and ensuring that pediatric patients receive the appropriate medications for their conditions while taking physiologic factors, polypharmacy, etc. into account. [6]
CONCLUSION:
150 people made up the study's sample. This study indicated that the prevalence of drug therapy problems among pediatric patients is high but in case of age group, prevalence of DTPs among the Pediatric patients was found to have no significant impact.This study highlights the significant risk factors associated with drug-related problems in pediatric patients. The findings suggest that several factors, such as age, gender, and the amount of medication administered, increase the risk of drug-related problems for young patients. The results of the study demonstrate the part clinical pharmacists can play in promoting better medication use and ensuring that children are prescribed the appropriate medications for their diseases while taking physiologic variables, polypharmacy, and other factors into consideration. This lessens the possibility of possible problems with pharmacological therapy.
ACKNOWLEDGEMENTS:
The authors would like to express their sincere gratitude to Srinivas College of Pharmacy as well as their gratitude to the study participants for a job well done.
REFERENCES
Christy T. Chacko, Syed Ziad Iqbal*, A. R. Shabaraya, A Prospective Observational Study to Assess the Prevalence of Drug Therapy Problems Among Pediatric Patients and Identify the Risk Factor Associated with Drug Therapy Problem in Pediatric Patients in A Tertiary Care Hospital, Int. J. of Pharm. Sci., 2025, Vol 3, Issue 1, 1423-1428. https://doi.org/10.5281/zenodo.14684545
10.5281/zenodo.14684545
