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Pharmaceutical interventions for drug-related problems in the neonatal intensive care unit: incidence, types, and
Norhan Attia Ahmed1, Ehab Ahmed Fouad2, Osama M El-Asheer3
1Department of Clinical Pharmacy, Faculty of Pharmacy, Assiut University, Assiut, Egypt.
Insights
Drug-related problems (DRPs) are frequent in neonatal intensive care units (NICUs). Clinical pharmacists play a vital role in identifying and resolving these issues, improving patient outcomes.
Area of Science:
- Neonatal intensive care
- Clinical pharmacy
- Drug safety
Background:
- Drug-related problems (DRPs) are a significant concern in hospitalized neonates, with limited existing research on their prevalence.
- Clinical pharmacists integrated into multidisciplinary teams are essential for preventing and mitigating DRPs in this vulnerable population.
Purpose of the Study:
- To identify and categorize DRPs within a neonatal intensive care unit (NICU).
- To determine factors contributing to DRPs in neonates.
- To document the interventions, outcomes, acceptance rates, and clinical significance of pharmacist actions.
Main Methods:
- A prospective, descriptive hospital study was conducted in the NICU of Assiut University Children's University Hospital, Egypt.
- Data were collected from August to November 2023.
- Drug-related problems were classified using the Pharmaceutical Care Network of Europe (PCNE) classification V9.1.
Main Results:
- Out of 316 neonates, 283 (89.6%) experienced 1723 DRPs (average 5.5 per patient).
- The most common DRP types were treatment effectiveness (46.4%) and treatment safety (26.4%), primarily caused by dose selection issues (61.9%).
- Pharmacist interventions led to 92% DRP resolution, with a 98.8% acceptance rate and 93% full implementation.
Conclusions:
- Drug-related problems are highly prevalent in the NICU setting.
- Clinical pharmacists are instrumental in the identification and resolution of DRPs.
- Factors such as length of hospital stay and the number of medications significantly correlate with DRP occurrence.
Abstract:
Background: Drug-related problems (DRPs) are widespread in hospitalized neonates, but studies on the prevalence of DRPs in this population are limited. The presence of clinical pharmacists on multidisciplinary teams helps prevent and reduce DRPs. Aim: This investigation aimed to identify and classify the incidence of DRPs in the neonatal intensive care unit (NICU), to determine the determining factors associated with DRPs and to document clinical pharmacists' interventions, outcomes, acceptance rates and clinical significance. Method: A prospective descriptive hospital study was conducted from August to November 2023 at the NICU of Children's University Hospital, Assiut University, Egypt. DRPs were classified using the Pharmaceutical Care Network of Europe (PCNE) classification V9.1. Results: Three hundred sixteen neonates were included in the study, with a mean gestational age of 34 ± 4 weeks and a mean birth weight of 2.03 ± 0.85 kg. A total of 1723 DRPs occurred among 283 neonates (89.6%), an average of 5.5 ± 5.1 DRPs per patient. The main types were treatment effectiveness (P1) (799, 46.4%), followed by others (P3) (469, 27.2%), and treatment safety (P2) (455, 26.4%). The leading causes were dose selection (C3) (1264, 61.9%) and "other domain" (C9) (543, 26.6%). Of the 2149 interventions introduced by pharmacists, 98.8% were accepted and 93% were accepted, and fully implemented. As a result, 92% of the DRPs were resolved. Both length of hospital stay and number of medications were significantly associated with DRPs. Conclusion: DRPs are common in the NICU; this study demonstrated the crucial role of clinical pharmacists in identifying and resolving DRPs.
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