The role of clinical Pharmacist and Pharmacologist in Identification of Drug related Problems in General and Internal Medicine

Hospitalized patients frequently experience drug-related difficulties (DRPs), particularly those who have polypharmacy and other comorbidities. In order to detect and address DRPs in a hospital context, this study intends to evaluate the effectiveness of an intervention conducted by a pharmacologist and clinical pharmacist. A six-month prospective interventional study (September 2023–February 2024) was conducted on all patients admitted to two internal medicine wards. Comprehensive clinical and demographic data were collected, including age, sex, comorbidities, and medications. DRPs were identified through structured medication assessments and prioritized for intervention based on their clinical relevance. Interventions included verbal recommendations, written consultations, or no action, depending on the DRP's severity. A total of 161 verbal recommendations were made, with 135 (84%) accepted by prescribers. Common DRPs included over-dosage (29%), adverse drug reactions (21%), and untreated indications (18%). Despite high acceptance of recommendations, 31% were not implemented. Polypharmacy was prevalent, with 89% of patients using five or more medications, contributing to a high risk of DRPs. The study highlights the significant impact of DRPs in hospitalized patients, particularly in the elderly with multiple chronic conditions and polypharmacy. While the intervention led to a high acceptance rate of recommendations, further efforts are needed to improve implementation rates, including written documentation and follow-up consultations. Regular medication reviews and interdisciplinary collaboration are crucial to optimizing drug therapy and enhancing patient safety in this high-risk population.