Role of pharmacists in reducing drug-related problems in hemodialysis outpatients

Objectives: Hemodialysis outpatients have a higher risk of developing drug-related problems. Pharmacists play a key role in identifying and preventing these drug-related problems. This study aimed to assess the effect of pharmacist intervention on the number and types of drug-related problems in outpatients undergoing hemodialysis at Indonesia Christian University Hospital. Methods: This pre- and post-prospective study was conducted from January 2013 to June 2013. We evaluated 86 patients who were prescribed 804 drugs. Results: A total of 337 drug-related problems were identified (41.86% of the total drugs prescribed). The types of drug-related problems identified were as follows: Failed therapy (18.69%); sub-optimal therapy (52.23%); indication of non-administration of therapy (2.37%); and non-allergic adverse drug effects (26.71%). The physicians received 59 recommendations, and the patients received 278 recommendations. These recommendations resulted in a decrease in ineffective drug therapy or therapeutic failure (18.69-0%), sub-optimal therapy (52.23-21.36%), indications of non-administration of drug (2.37-2.08%), and non-allergic adverse drug effects (26.71-9.20%). The factors that significantly affected the occurrence of drug-related problems were hemodialysis frequency, number of comorbidities, and number of drugs prescribed. Patients undergoing hemodialysis 3 times a week were more likely to experience a decrease in drug-related problems than those undergoing hemodialysis twice a week (odds ratio 26.33, 95% confidence interval 2.710-255.884). Conclusions: Pharmacist intervention could decrease drug-related problems in hemodialysis patients.