Kardiyak Cerrahi Hastalarında Preoperatif ve Postoperatif Dönemde Risk Analizi ile İlaç Tedavisinin İncelenmesi

Abstract

This study aimed to identify drug related problems (DRPs), analyze the risks and evaluate the impact of a clinical pharmacist in risk management process of cardiac surgery. Prospective, quasi-experimental study was conducted at the department of cardiac-surgery in Hacettepe University Hospitals between November 2019-May 2021. DRPs were identified at both periods of the study and categorized according to the Pharmaceutical Care Network Europe system. The causes of DRPs (as the risks) identified in the first period were scored by the expert panel (consisted of five) in terms of frequency, severity and probability; then were categorized as acceptable, definite, important and high and preventive/mitigative activities were planned by the panel. At the second period, preventive/mitigative activities were carried out by a clinical pharmacist. The patients aged ≥18 years and with a planned elective cardiac-surgery, were included and monitored during hospital stay. For each period, 100 patients were included. At the first period, a total of 275 DRPs and 487 causes were determined, thereby preventive (medication reconciliation, medication review and educational materials) and mitigative (interventions for a problem) activities were planned. At the second period, a total of 215 DRPs and 304 causes were determined. In comparison between observation and intervention periods, there was a decrease in high risks (17.7% and 0%) and increase in acceptable risks (32.6% and 84.9%) related with the causes of DRPs by the implementation of planned activities (p<0.001). The quality of life (physical and mental) of the patients increased significantly at hospitalization, discharge and one month follow-up (p<0.001). Therefore, a contribution of clinical pharmacists into cardiac-surgery process, via assessment of the risk related with DRPs and implement the preventive and mitigative activities, would contribute to the improvement of patient care services.