The pharmacists' interventions after a Drug and Therapeutics Committee (DTC) establishment during the COVID-19 pandemic.

Amira B Kassem, Ahmad Z Al Meslamani, Dina H Elmaghraby, Yosr Magdy, Mohamed AbdElrahman, Ahmed M E Hamdan, Hebatallah Ahmed Mohamed Moustafa
Author Information
  1. Amira B Kassem: Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, Egypt. ORCID
  2. Ahmad Z Al Meslamani: College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.
  3. Dina H Elmaghraby: Kafr El Dawar General Hospital, Department of infectious disease, Ministry of Health, Beheira, Egypt.
  4. Yosr Magdy: Kafr El Dawar General Hospital, Department of infectious disease, Ministry of Health, Beheira, Egypt.
  5. Mohamed AbdElrahman: Clinical Pharmacy Department, College of Pharmacy, Al-Mustaqbal University, Babylon, Iraq.
  6. Ahmed M E Hamdan: Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia.
  7. Hebatallah Ahmed Mohamed Moustafa: Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Badr University in Cairo, Badr, Egypt. ORCID

Abstract

Introduction: Healthcare systems in developing countries faced significant challenges during COVID-19, grappling with limited resources and staffing shortages. Assessment of the impact of pharmaceutical care expertise, particularly in critical care units during the pandemics, in developing countries remains poorly explored. The principal aim of our study was to assess the impact of the Drug and Therapeutics Committee (DTC), comprising clinical pharmacists, on the incidence, types, and severity of medication errors and associated costs in using COVID-19 medications, especially antibiotics.
Methods: An interventional pre-post study was carried out at a public isolation hospital in Egypt over 6 months.
Results: Out of 499 medication orders, 238 (47.7%) had medication errors, averaging 2.38 errors per patient. The most frequent were prescribing errors (44.9%), specifically incorrect drug choice (57.9%), excessive dosage (29.9%), treatment duplication (4.5%), inadequate dosage (4.5%), and overlooked indications (3.6%). Linezolid and Remdesivir were the most common medications associated with prescribing errors. Pharmacists intervened 315 times, primarily discontinuing medications, reducing doses, introducing new medications, and increasing doses. These actions led to statistically significant cost reductions ( < 0.05) and better clinical outcomes; improved oxygen saturation, decreased fever, stabilised respiratory rates, and normalised white blood cell counts. So, clinical pharmacist interventions made a notable clinical and economic difference (66.34% reduction of the expenses) in antibiotics usage specifically and other medications used in COVID-19 management during the pandemic.
Conclusion: Crucially, educational initiatives targeting clinical pharmacists can foster judicious prescribing habits.

Keywords

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Word Cloud

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