Characterization of drug related problems occurring in iranian ambulatory patients and the acceptance rate of clinical pharmacist’s recommendations by physicians

Rationale, aims and objectives: Performing medication review by pharmacists is an effective strategy in reducing the incidence of drug-related problems (DRP). This study aimed to investigate the characterization of DRP and clinical pharmacist’s interventions in Iranian ambulatory patients. Method: From June 2018 to May 2019, 204 ambulatory patients who had risk-factors for DRP were referred to the pharmacotherapy service in a specialty and subspecialty clinic of a tertiary hospital in Hamadan, Iran. A comprehensive medication review was carried out by a clinical pharmacist for each patient and appropriate interventions were made to prevent or resolve identified DRP. The acceptance rate of the interventions by the physicians was also recorded. Results: Totally, 899 DPR were identified in the study patients, with the mean number of 4.4 DRP per patient. The most frequent DRP were related to education and information and adherence to medications. DRP were more frequently present in females and patients with older ages, lower educational levels, and higher numbers of disease conditions and medications. A total of 1,056 interventions were made by the clinical pharmacist (an average of 5.17 interventions per patient). Providing information and education to the patients, followed by referral to other specialists were the most frequent interventions. Nearly half of the clinical pharmacist’s recommendations (43.41%) were accepted by the physicians. Conclusions: This study showed that DRP are relatively common in Iranian ambulatory patients and clinical pharmacist can have beneficial roles in identifying and resolving DRP. However, the acceptance rate of clinical pharmacist’s recommendations by the physicians in Iran is yet low