Evaluation of clinical pharmacy services in patients receiving antithrombotic treatment

Antithrombotic drugs are commonly used in the cardiology ward, and it is believed that these patients may be susceptible to drug-related problems (DRPs). The aim of this study is to evaluate the clinical pharmacy services for detecting and preventing DRPs in patients receiving antithrombotic treatment. The study was designed as a prospective randomized controlled study in two groups. It was conducted in the cardiology ward of a university hospital between November 2021 and November 2022. DRPs and their causes were identified in the control and interventional groups and recommendations were made to physicians for clinically significant DRPs in the intervention group by the clinical pharmacist. DRPs were classified according to PCNE (Pharmaceutical Care Network Europe) v9.1. Patients were evaluated for readmissions to the hospital within 1 and 3 months after discharge. A total of 400 patients were included in the study. The mean age of patients in the control and intervention groups were found to be 67.2±12.2 and 67.8±12.3, respectively. Coronary artery disease (74.5%; 74.5%) and hypertension (70.5%; 70%) were determined as the most common diseases. The number of identified DRPs was 561 in the control group and 497 in the intervention group. The most common problem identified in both groups was related to treatment safety (73.62%; 74.25%), followed by treatment efficacy (24.06%; 23.14%). The main reasons for DRPs were reported to be drug selection (81.11%; 80.88%) and dosage selection (19.08%; 16.10%). Interventions were provided for 248 out of 266 clinically significant DRPs identified during the study. Of these interventions, 235 (94.76%) were accepted by physicians. The most common interventions at the drug level were changing the dosage (29.65%) and starting a new medication (28.49%). Although no significant difference was found between the groups in terms of hospital readmission within 1 and 3 months (p>0.05), numerical decreases were observed in the intervention group. In our study, a high number of DRPs were observed in both groups. The high acceptance rate of recommendations regarding the issues in the intervention group showed a positive contribution of clinical pharmacists in reducing DRPs. These results demonstrate that involving clinical pharmacists in the healthcare team and expanding their services can provide better healthcare. Clinical pharmacists can help to manage patients' treatment process more effectively and efficiently by playing a more active role in hospitals.