An approach of clinical pharmacist pertaining to solve drug related problems in pediatric patients

S. Suwitha, Mohammed Fardan, Aswathy M. Shaji, Jimmer Joe, K. Hasif, A. Priya, K. Arun Chander Yadav


Background: The objectives of the study were to assess the outcomes of clinical pharmacist intervention in solving drug related problems in pediatric patients and to identify the drug related problems in accordance with the causes observed.

Methods: It was a prospective observational study done over a period of six months (October 2019 to March 2020) at Apollo children’s hospital in Chennai.

Results: Total of 480 subjects were enrolled into the study, out of which 248 were male children and 232 were female children. The patients were divided into 4 age groups. In this study 60.41% pediatric patients were prescribed with less than 5 drugs 290 (60.41%). Drug related problems which were identified during the study was classified according to Pharmaceutical Care Network Europe (PCNE) and drug-related problem (DRP) classification (v9.00). The most frequent DRP was drug choice problem 37 (33.33%). The total number of caused drug related problems was 73 and same number of interventions was given by clinical pharmacist. The most frequent cause of drug related problems was identified as dose selection 31 (42.46%). Outcomes of interventions revealed that 70 (95.89%) problems were solved overall.

Conclusions: In this study, clinical pharmacist’s level of involvement has shown interesting results. Moreover, they play an essential role in improving patient safety and outcome, reducing cost and providing quality of care for ill patients.


Drug related problems, Adverse drug reaction, Drug interactions, PCNE classification and pediatric patients

Full Text:



Covert KL, Mardis CR, Fleming JN, Pilch NA, Meadows HB, Mardis BA, et al. Development of a Predictive Model for Drug‐Related Problems in Kidney Transplant Recipients. J Am Coll Clin Pharm. 2016;32(1):159-69.

Foppe van Mil JW, Westerlund LOT, Kurt E Hersberger, and Marion A Schaefer. Drug-Related Problem Classification System. ANN Pharmacother. 2004;38(5):859-67.

Brennan TA, Leape LL, Laird NM, Hebert L, Localio AR, Lawthers AG, et al. Incidence of adverse events and negligence in hospitalized patients. Results of the Harvard Medical Practice Study. IN Engl J Med. 1991;325(3):210.

Barber N, Rawlins M, Franklin BD. Reducing prescribing error: competence, control and culture. Qual Saf Health Care. 2003;12(Suppl 1):i29‐i32.

Poon EG, Cina JL, Churchhill W, Patel N, Rothschild JM, Keohane CA, et al. Medication Dispensing Errors and Potential Adverse Drug Events before and after Implementing Bar Code Technology in the Pharmacy. Ann Intern Med. 2006;145(6):426‐34.

Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, et al. Incidence of adverse drug events and potential adverse drug events: implications for prevention. JAMA 1995;274(1):29‐34.

Mangasuli S, Rao Padma GM. Clinical intervention: A preliminary survey in a South Indian teaching hospital. Ind J Pharmacol. 2006;38(5):361-2.

PMLA van den Bemt, PhD Professor ACG Egberts. Drug-related problems: definitions and classification. EJHP Practice. 2007;13.

Bird JA, Lipton HL. The impact of clinical pharmacist’s consultations on geriatric patient’s compliance and medical care use: a randomized controlled trial. Gerontologist. 1994;34(3):307-15.

Hanlon JT, Weinberger M, Samsa GP, Schmader KE. A randomized, controlled trial of a clinical pharmacist intervention to improve inappropriate prescribing in elderly outpatients with Polypharmacy. Am. J Med. 1996;100(4):428-37.

Abbott RD, Bogden PE, Koontz LM, Onopa JK, Williamson P. Comparing standard care with a physician and pharmacist team approach for uncontrolled hypertension. J Gen Intern Med. 1998;13(11):740-5.

Donovan JL, Drake JA, Tran MT, Whittaker P. Pharmacymanaged anticoagulation: assessment of in-hospital efficacy and evaluation of financial impact and community Acceptance. J Thromb Thrombolysis. 2006; 22(1):23-30.

Allen KM, Bright J, Carey DL, Doecke CJ, Dooley MJ, Galbraith KJ, et al. Prospective multicentre study of pharmacist initiated changes to drug therapy and patient management in acute care government funded hospitals. Br J Clin Pharmacol. 2004;57(4):513-21.

PCNE Classification for Drug-Related Problems V9.00.

Rasmussen M, Struck PA. Pilot study of pharmacist initiated interventions in drug therapy in an Australian pediatric hospital. EJHP. 2007;13:105-12.

Ganachari MS, Mahendra Kumar BJ, Wali SC, Fibin M. Assessment of Drug Therapy Interventions by Clinical Pharmacist in a Tertiary Care Hospital. Ind J Pharm Pract. 2010;3:22-8.

Muhammad Umair Khan, Akram Ahmad, The Impact of Clinical Pharmacists’ Interventions on Drug Related Problems in a Teaching Based Hospital. Int J Pharm Clin Res. 2014;6(3):276-280.