Pharmacist-Led Interventions to Reduce Drug-Related Problems in Prescribing for Pediatric Outpatients in a Developing Country: A Randomized Controlled Trial

Phuong Minh Nguyen; Kien Trung Nguyen; Suol Thanh Pham; Vy Tran Thanh Le; Tu Cam Thi Le; Han Gia Diep; Ngoc Nguyen Minh Le; Hung Huynh Vinh Ly; Trang Thi Nhu Nguyen; Anh Nhut Lam; Thao Huong Nguyen; Thang Nguyen

doi:10.5863/1551-6776-28.3.212

Pharmacist-Led Interventions to Reduce Drug-Related Problems in Prescribing for Pediatric Outpatients in a Developing Country: A Randomized Controlled Trial

J Pediatr Pharmacol Ther. 2023;28(3):212-221. doi: 10.5863/1551-6776-28.3.212. Epub 2023 Jun 2.

Authors

Affiliations

¹ Faculty of Medicine (PMN, TKN, HHVL), Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
² Department of Pharmacology and Clinical Pharmacy (STP, TTCL, HGD, TN), Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
³ Faculty of Pharmacy (KT), University of Groningen, Groningen, the Netherlands.
⁴ Department of Pharmacy (VTTL), Can Tho Children's Hospital, Can Tho, Vietnam.
⁵ Department of Traditional Medicine (NMNL), Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
⁶ Office of Sciences and Technology - External Relations (TTNN), Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
⁷ Faculty of Public Health (ANL), Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.
⁸ Department of Clinical Pharmacy (THN), University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.

Abstract

Objective: To evaluate a pharmacist-led intervention's effectiveness in reducing drug-related problems (DRPs ( related to prescriptions for pediatric outpatients.

Methods: We conducted a randomized controlled trial. We recruited and randomly assigned 31 physicians to control or intervention groups. We collected 775 prescriptions (375 from the control group and 400 from the intervention group) at the start. For 3 weeks, intervention physicians received additional information and meetings with pharmacists in addition to the usual practices of the hospital. We then collected prescriptions at the end of the study. We classified DRPs, based on reliable references (Supplemental Table S1) at baseline and endpoint (a week after the intervention). The primary outcome was the proportion of prescriptions with DRPs, and secondary outcomes were the proportions of prescriptions with specific DRP types.

Results: The influence of the intervention on general DRPs and specific DRPs was the study's main finding. The pharmacist-led intervention helped reduce the prescriptions with DRPs proportion in the intervention group to 41.0%, compared with 49.3% in the control group (p < 0.05). The DRPs proportion related to the timing of administration relative to meals, unlike the other DRP types, increased in the control group (from 31.7% to 34.9%) and decreased in the intervention group (from 31.3% to 25.3%), with a significant difference between the 2 groups at endpoint (p < 0.01). Patients aged >2 to ≤6 years (OR, 1.871; 95% CI, 1.340-2.613) and receiving ≥5 drugs (OR, 5.037; 95% CI, 2.472-10.261) were at greater risk of experiencing DRPs related to prescribing.

Conclusions: A pharmacist-led intervention improved DRP occurrence related to physicians' prescribing. Pharmacists could be involved in in-depth research with physicians in the prescribing process to provide tailored interventions.

Keywords: DRPs; Vietnam; drug-related problems; outpatients; pediatrics; pharmacist-led interventions; prescribing.