Adverse Drug Reaction (ADR)

Medication error is an essential variable to determine patient safety. So it is crucial to realize the bottle necks of care giving. Studies proved that the role of clinical pharmacist can attribute to positive outcomes in patient care. The main objective is to assess the impact of the interventions provided by clinical pharmacist in the medical wards. Secondary objectives comprise of evaluating the impact of intervention in the patients with renal failure, assessing the acceptance by physician and estimating the effect of intervention in cost saving. The set of interventions collected are regrouped into various categories like indications, safety, dosing and miscellaneous. Under each category, sub-categories are listed and their respective percentages are explained using pictorial representation. Also, the acceptance rate of the interventions by the physician is calculated. The cost saving accrued because of the interventions is estimated to look into to know how the role of clinical pharmacist can help the patients economically. The interventions are regrouped into: indication – 36.3 %; safety – 40.8 %; dosing – 16.03 % and miscellaneous – 6.8 %. Majority of the interventions are given for safety and the acceptance rate of the interventions by the physicians is high – 87.2 %. It is also found that 40 % of these interventions accrued to cost saving to the patients. There is a possibility of multiple benefits, by allotting a clinical pharmacist for every medical team in the ward. This strategy helps the patients to gain better health care and cost saving.

The field of patient’s drug safety has been receiving great deal of attention, since adverse drug reaction has been recognized as hazards of drug therapy. Adverse drug reactions are a great cause of concern to the healthcare professionals, patients and the pharmaceutical industry. However, may times it goes undetected and ignored by the patients and healthcare professionals. Hence we took a prospective observational study to analyse the Adverse Drug reactions among all patients admitted in general medicine department in Justice KS Hegde Charitable Hospital, Mangalore. The study was carried out for a period of eight months from September 2012 to April2013. The suspected adverse drug reactions were later analysed for their causality, severity and preventability by using the different adverse drug reaction assessment scales. A total of 640 cases has been followed and 47 Adverse Drug Reactions has been reported from the 40 patients during the study period. Male predominance was noted over females in case of total number of patients. Majority Adverse Drug Reactions were in the age group 70-79(31.91%). The most common class of drugs involved in adverse drug reactions is Antibiotics (17.39%) followed by Antihypertensive 7(15.21%). The most common system involved in adverse drug reaction is Digestive system (19.36%) followed by dermatological system (13.04%). Out of the 47 adverse drug reactions reported, 53% were probable, 45% were possible and 2% were unlikely. The severity assessment done by using the Hartwig and Seigel scale indicate that majority of the ADRs were ‘Mild’ followed by moderate and severe respectively. The preventability assess shows that most of ADRs are Probably Preventable 28(59.57%) followed by Not preventable 16(34.04%) and definitely preventable 3(6.38%). Monitoring and reporting of adverse drug reactions in the hospital is one of the best method to identify the causality between exposure to the drug and the occurrence of adverse drug reaction. Proper education and training to the healthcare professional’s towards ADR reporting will have a positive attitude towards continuous reporting and improving patient safety.