Drug therapy problems (DTPs) are any unwanted incidents related to drug therapy that can potentially or actually affect the desired goals of treatment. Patients with heart failure (HF) are particularly prone to DTPs due to their multiple prescriptions and comorbidities. To assess the prevalence of DTPs, data collectors participated in medical room rounds to document each drug treatment, and each patient's compliance with prescribed drug therapy was assessed through semi-structured interviews. The results of the study showed that the need for additional drug treatment was the most common DTP identified, accounting for 25.2%.
This finding was similar to the results of a study conducted in four French-speaking countries and five paediatric clinics in Greece, which reported that additional drug requirements were the most common DTP with 25% and 28%, respectively. DTPs related to the indication may be classified as either “unnecessary drug therapy” or “need for additional drug therapy”. In addition, a large number of pharmacotherapy problems remain unresolved due to the unavailability of some recommended drugs and the inability of patients to afford research and drug costs. Antibiotics were the main class of drugs involved in DTPs, and errors in prescribing and calculating the dose were identified as significant risk factors.
Ceftriaxone (25.81%) was the most common specific drug prone to DTPs, followed by spiranolactone (14.52%), enalapril (6.45%) and furosemide (6.45%). A DTP can occur when the dose is too low to produce the desired result, or when the dosage interval is too infrequent, or when a drug interaction reduces the amount of active drug available or when the duration of therapy is too short. Of all DTPs identified in this study, additional pharmacotherapy needs were the most common, accounting for 35.85%. This can also be attributed to prescribing drugs for cases that are self-limited and for those who do not need drug treatment at the time of prescription, as well as prescribing drugs that are inappropriate for the compilation indication.
Antibiotics were found to be the most common class of drugs involved in DTPs (40.32%), followed by cardiovascular drugs (37.1%) and non-steroidal anti-inflammatory drugs (4.84%). The secondary objectives included assessing intrarater reliability between investigators' severity ratings and assessing the likelihood of adverse drug reaction damage by drug classes. In conclusion, DTPs are any undesirable events experienced by a patient related to drug therapy that interfere with achieving desired goals of therapy. Drug-related problems fall into seven categories: unnecessary drug therapy, need for additional medications, ineffective drugs, too low dose, too high dose, adverse drug reaction, and non-compliance.