MEDICATION ERRORS AND DRUG THERAPY RELATED PROBLEMS IN HYPERTENSIVE CARDIOVASCULAR PATIENTS: A PROSPECTIVE EVALUATION USING THE PCNE CLASSIFICATION IN A CRITICAL CARE SETTING
DOI:
https://doi.org/10.64105/bmf9nt69Abstract
Medicines are essential in modern healthcare, contributing to the prevention, diagnosis, and management of disease. When misused, however, they may lead to drug therapy–related problems (DTRPs) such as medication errors and adverse drug reactions. Critically ill patients with cardiovascular disease and hypertension are particularly vulnerable because of complex treatment regimens. Although international studies highlight the role of clinical pharmacists in reducing such problems, their participation in patient care remains limited in Pakistan. This study applied the Pharmaceutical Care Network Europe (PCNE) classification system (v9.1) to assess DTRPs among hypertensive patients in a critical care setting. Objective: To identify and classify DTRPs using the PCNE system (v9.1) among hypertensive cardiovascular patients admitted to the Critical Care Unit (CCU) of DHQ Hospital Kohat, and to evaluate the contribution of clinical pharmacists in addressing these problems. Methods: This prospective observational study was carried out over six months (December 2024–May 2025). Adult inpatients (>18 years) diagnosed with cardiovascular disease and hypertension were included. From 180 patient records, 100 were selected according to inclusion criteria. Data on demographics, clinical conditions, and treatments were collected using structured forms. DTRPs were identified and classified using Micromedex, Lexicomp, Medscape, and standard clinical references. Data analysis was performed with Microsoft Excel and SPSS version 16.0. Results: A total of 463 DTRPs were identified, with a mean of 4.77 per patient. The most frequent categories were suboptimal therapeutic effect (32.18%), potential adverse drug events (28.29%), and prescriptions without clear indication (19.65%). Inappropriate drug combinations represented 12.95% of cases. The most common interventions involved drug withdrawal or dose adjustment (25.05%) and control of antibiotic use (21.59%). Higher age and multiple comorbidities were significantly associated with increased frequency of DTRPs. Conclusion: The study shows a considerable burden of preventable DTRPs among hypertensive cardiovascular patients in the CCU. Clinical pharmacist involvement was effective in resolving many of these problems. Strengthening the role of pharmacists within multidisciplinary teams can improve therapeutic outcomes and enhance medication safety in public sector hospitals.
Keywords: Drug Therapy-Related Problems, Clinical Pharmacist, Cardiovascular Disease, Critical Care Unit (CCU), Pharmaceutical Care Network Europe (PCNE) Classification
