Evaluation and Management of Drug-Drug Interactions in Patients Hospitalized in Nephrology and Post-Transplant Wards in a Teaching Hospital

  • Mojtaba Shafiekhani Shiraz University of Medical Sciences
  • Sara Tarighati Shiraz University of Medical Sciences
  • Ehsan Mirzaei Shiraz University of Medical Sciences
  • Soha Namazi Tehran University of Medical Sciences
Keywords: Adverse drug events, Clinical pharmacist, Drug-Drug interaction, Immunosuppressant, kidney transplant

Abstract

Background: Kidney transplant patients usually take a combination of medications after transplantation; hence medication safety becomes an important issue in order to maintain the new organ working properly.

Objective: To evaluate the incidence and risk factors associated with potential drug-drug interactions (pDDIs) in hospitalized patients in Nephrology and Post-transplant wards to improve clinical management of pDDIs by a clinical pharmacist.

Methods: Patients in Nephrology and Post-transplant wards were screened for pDDIs, using the interaction screening program Lexi-comp resource®. After evaluating the detected pDDIs for clinical relevance, intervention was implemented through physicians or nurses for type D and X drug interactions. Intervention feedback, implemented recommendations and any probable adverse drug reactions were documented.

Results: During the study, 399 patients (239 in nephrology and 160 in post-transplant wards) plus 6105 drug orders were evaluated, and a total of 3263 DDIs were identified of which 827 (23.5%) were determined to be D and X classifications, and a total of 89.97 % of all hospitalized cases had at least 1 pDDIs. Factors that had the greatest influence on pDDI incidence included number of drugs and the admitted wards. Patients in post-transplant ward experienced 2.3 times more DDIs than patients in nephrology ward. In total, 78% of class X and D DDIs required intervention of which 75% were accepted and implemented by the physicians and nurses.

Conclusion: Clinically relevant pDDIs are common in patients in Nephrology and Post-transplant wards, and pharmacists play a critical role in detecting and managing this medical problem in hospitalized patients.

Author Biographies

Mojtaba Shafiekhani, Shiraz University of Medical Sciences

Department of clinical pharmacy

Ehsan Mirzaei, Shiraz University of Medical Sciences

Department of clinical pharmacy

Soha Namazi, Tehran University of Medical Sciences

Department of clinical pharmacy

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Published
2020-03-24
How to Cite
1.
Shafiekhani M, Tarighati S, Mirzaei E, Namazi S. Evaluation and Management of Drug-Drug Interactions in Patients Hospitalized in Nephrology and Post-Transplant Wards in a Teaching Hospital. J Pharm Care. 8(1):16-22.
Section
Original Article(s)