SCREENING OF DRUG RELATED PROBLEMS IN HIV PATIENTS RECEIVING ANTI RETROVIRAL THERAPY

摘要

Aim: The main aim of the study is prospective screening of drug related problems in ART receiving patients at RIMS Kadapa. Objectives: The key objectives of the study include To identify various drug related problems using various domains as per PCNE (Pharmaceutical care network Europe). To identify the most common ART regimen causing DRP. Methodology: A prospective observational study conducted for a period of six months november2015-april 2016. The data was collected by using Patient Data Collection Form, PCNE classification V5.01, Drug interaction form, ADR form. The collected data was analysed for age and gender distribution, distribution of patients based on co morbidities, patients with and without DRPs based on type of ART regimen used, distribution of problems, causes for different problems, interventions suggested for different problems then outcome of interventions were calculated. Results: A total of 125 patients 104 members experienced DRPs with ART regimens, which accounts 63(60.57%) males and 41(39.42%) females. Out of 104 patients 59 members experienced DRPs with ZLN regimen. In those patients the main DRPs were adverse drug reactions, drug use problems and drug interactions. The main causes for those problems were Pharmacokinetic problems incl. Ageing/ deterioration in organ function and interactions (C1.4), manifest side effect no other cause (C1.8) as per PCNE scheme V5.01. The various interventions suggested for those problems were Patient (medication) counselling (I2.1), Instructions for use changed to......(I3.4), new drug started(I3.6). the outcomes for suggested interventions were problems( Rashes, muscle pain, vomiting, nausea, headache, cough, abdominal pain.....etc.) totally solved(O1.0) and problems (Neutropenia, anaemia, hyper pigmentation of skin & nails, ear impairment, severe anaemia, finger paralysis, blurred vision.....etc.) were partially solved(O2.0). Conclusion: Our study concludes adverse drug reactions with ART are high in problems domain as per PCNE, which can be decreased by identifying DRPs in early stages of drug therapy, prescribing other drugs cautiously in HIV patients. Majority of DRPs can be decreased by improving patient-physician relationships and patient-pharmacist relationships. For better outcomes patient counselling can be considered as a better interventional tool which will improve adherence and decrease DRPs in HIV patients.