| DOI: 10.29090/psa.2025.04.25.5474 | Pharm Sci Asia 2025; 52(4), 532-540 |
Drug-related problems and clinical pharmacist interventions in prescribing for older outpatients in VietnamThang Nguyen PhD 1*, Duong Bui Thuy Le MSc1, Suol Thanh Pham PhD 1, Ngoc Dung Lam MSc1, Quyen Nguyen Tu Le BPharm1, Tu Thi Cam Le MSc1, Trang Thi Nhu Nguyen MSc1, Phuong Minh Nguyen PhD2, Tan Thanh Nguyen PhD2, Tan Van Ngo PhD2, Ngoc Thi Nhu Duong MSc3, Nghia Van Le PhD4.
1 Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
2
Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
3
Department of Health, Vinh Long Province, Vietnam
4
Nguyen Dinh Chieu Hospital, Vinh Long Province, Vietnam
Drug-related problems (DRPs) are a leading cause of treatment failure, hospital admissions, and mortality, particularly among older adults due to age-associated alterations in pharmacokinetics and pharmacodynamics. Vietnam is experiencing a rapidly aging population, with increasing rates of chronic diseases and polypharmacy, while its healthcare system continues to face challenges in delivering specialized geriatric care. This study aimed to evaluate the prevalence and determinants of DRPs in geriatric outpatient prescriptions and assess the impact of clinical pharmacist-led interventions on DRP reduction. A quasi-experimental study was conducted across three hospitals in Vietnam, analyzing prescriptions from patients aged ≥65 years. DRPs were identified and classified using the Pharmaceutical Care Network Europe (PCNE) criteria version 9.1. Clinical pharmacists implemented educational interventions targeting prescribers to address identified DRPs. Data were analyzed using descriptive statistics, t-tests or Mann-Whitney U tests for continuous variables, Chi-square tests for categorical variables, and multivariable logistic regression to identify factors associated with DRPs. In the pre-intervention phase, 1,651 prescriptions were reviewed; the mean patient age was 71.4 years, with 58.8% female. The proportion of prescriptions containing at least one DRP was 28.3%, with inappropriate drug indication being the most prevalent issue. Polypharmacy (≥5 medications) and a higher number of diagnoses per patient were significant predictors of DRPs. Post-intervention analysis demonstrated a statistically significant reduction in DRP prevalence. Clinical pharmacist-led interventions effectively reduced the prevalence of DRPs in geriatric outpatient settings (p < 0.001). These findings underscore the critical role of clinical pharmacists in optimizing medication regimens for older adults, thereby enhancing patient safety and treatment outcomes.
Keyword:
Drug-related problems; Clinical pharmacist intervention; Geriatric outpatients; Polypharmacy; Vietnam.
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