OBJECTIVES :

• Identifying and classifying drug related problems (DRPs) in SLE patients
• To provide clinical pharmacist interventions to resolve DRPs in SLE patients
• To identify the predictors of DRPs in SLE patients

METHODS

A prospective, observational study was conducted at the Department of Rheumatology in an 1800 bedded tertiary care teaching hospital in South India from June 2019 to March 2020. A pharmacist-led multidisciplinary team was formed to assess the DRPs and implementation of the clinical pharmacist interventions to resolve DRPs. Patients of any age and gender diagnosed with SLE according to ACR-1997 guideline were enrolled in this study upon their consent. PCNE DRP classification v8.02 was used to assess DRPs. The categorical variables were presented in percentile, tabulation, and bar chart. Using SPSS v25, descriptive statics applied for continuous variables and logistic regression (95% Cl, P<0.005) applied to evaluate predictors of DRPs.

RESULTS :

A total of 127 patients with SLE were enrolled in this study. The mean age was 39.05±13.47 years (range:15-61), with 87.40% female. The median score of SLEDAI-2K was 8 (IQR: 5-11). An average of prescribed medications was 9.87±2.81 per patient. A total of 228 DRPs were reported with an average of 1.7±1.09 problems per patient, mostly related to treatment safety (42.24%). Overall, 289 causes of DRPs were identified, of which 24.5% were related to the “drug use process”. Clinical pharmacist proposed interventions for all DRPs, majority were at “drug level (41.29%). Of the interventions proposed, 97.27% were accepted, leading to 94.2% of DRPs being resolved. The major three predictors significantly (p<0.0001*) associated with DRPs were female gender, polypharmacy (>5 drugs) and hydrocortisone, an odds ratio of 3.22[1.90-9.01], 3.61 [0.81-22.4] and 6.23 [3.41-29.10] respectively.

CONCLUSIONS :

Extending the clinical pharmacist interventions helps SLE patients to minimize drug related problems, economic burden, and enhance therapeutic effectiveness.