Drug-related problems and their predictors in pediatric community-acquired infections: the role of pharmacist-led

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Published on: August 30, 2018

Sana Ali1, Ale Zehra1, Fakhsheena Anjum1

  • 1Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Dow College of Pharmacy, Dow University of Health Sciences, Karachi, Sindh, Pakistan.

Journal of Pharmacy & Pharmaceutical Sciences : a Publication of the Canadian Society for Pharmaceutical Sciences, Societe Canadienne Des Sciences Pharmaceutiques
|July 31, 2026
PubMed

Insights

Drug-related problems (DRPs) are common in hospitalized children, particularly dose selection errors. Pharmacist interventions effectively resolved DRPs and yielded significant cost savings, supporting pharmacy integration in low- and middle-income countries.

Area of Science:

  • Pediatric Pharmacology
  • Health Economics
  • Clinical Pharmacy

Background:

  • Drug-Related Problems (DRPs) pose a significant risk of preventable harm in hospitalized children, with limited data from low- and middle-income countries (LMICs).
  • Community-acquired infections (CAIs) are common in pediatric populations, increasing the potential for DRPs.
  • Understanding the prevalence, severity, and determinants of DRPs is crucial for developing targeted interventions.

Purpose of the Study:

  • To determine the prevalence, severity, and determinants of DRPs in hospitalized children with CAIs.
  • To quantify the clinical and economic impact of pharmacist-led interventions in managing DRPs.
  • To provide evidence for the integration of clinical pharmacy services in LMICs.

Main Methods:

  • A prospective interventional study was conducted in a tertiary care public hospital in Pakistan.
  • Trained pharmacists reviewed medication orders daily, identifying and classifying DRPs using standard criteria (PCNE V9.1 and NCC MERP).
  • Pharmacist interventions were proposed to physicians, and their acceptance and DRP resolution rates were recorded. Logistic regression identified DRP predictors, and cost savings were calculated.

Main Results:

  • A total of 2,010 DRPs were identified in 400 patients (5.03 DRPs/patient), with dose selection errors being the most frequent (58.13%).
  • Approximately 9% of DRPs had the potential for serious harm. Pharmacist interventions achieved a 98.7% acceptance rate and 81.1% DRP resolution.
  • Significant cost savings of PKR 363,184 (USD 1,290) were observed over 10 months, with a 142% return on investment.

Conclusions:

  • DRPs are prevalent in hospitalized children with CAIs, with dose selection errors being a major concern.
  • Pharmacist-led interventions are highly effective in resolving DRPs and generating substantial cost savings.
  • Integrating clinical pharmacy services into healthcare systems in LMICs is essential for improving patient safety and economic outcomes.
Abstract

Keywords:
Pakistancommunity-acquired infectionsdrug-related problemseconomic impactmedication safety

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