Analysis of drug-related problems in ischemic stroke in-patients in one Indonesian district hospital

Background: Ischemic stroke is one of the leading causes of death in Indonesia. Appropriate management, including the identification of drug-related problems (DRPs), is needed to prevent disability and death.

Objective: This study aimed to analyse DRPs as defined by the Pharmaceutical Care Network Europe (PCNE).

Method: This was a cross-sectional research using the medical records of in-patients with ischemic stroke aged >18 years.

Result: Out of the 115 patients examined, 51.3% were male, and the mean age was 57.85 + 10.539 years. Exactly 204 cases of DRPs and 175 causes appeared in 101 patients. A total of 58 patients experienced one-to-two problems, and 43 patients experienced more than two problems. The problems domain consists of therapeutic effectiveness (P1, 133(65.2%)), adverse effects (P2, 67(32, 84%)), and medical expenses (P3, 4(1, 96%)). The DRPs mostly involved antihypertension and antiplatelet. The most common cause was a new indication for treatment (C1.9, 51(29.14%)) and drug interactions (C8.1, 48(27.43%)). Multivariate analysis of patient characteristics showed that patients taking more than eight medications were more likely to experience more than two DRPs than those on one-to-four medications (OR 5.593; 95%, CI 1.015-30.812).

Conclusion: Most patients experienced one-to-two DRPs with the highest being a potentially suboptimal treatment. Clinical pharmacists are expected to monitor therapy, especially in polypharmacy patients.