Drug Related Problems Among Patients in the Critical Care Unit of Kenyatta National Hospital

Abstract

Background: Drugs are usually prescribed with the intention of achieving desirable therapeutic outcome(s), and alleviate patient suffering. However, the use of drugs more often than not may cause undesired outcomes, commonly known as drug/ medication related problem(s). Critically ill patients tend to be at risk of drug related problems due to a number of factors, such as the state of illness, polypharmacy, inability to participate in their care among others. Study objective: This study aimed at characterizing drug therapy problems and their contributory factors in patients admitted in intensive care unit of Kenyatta National Hospital (KNH). Study design and participants: A cross-sectional design study was conducted at the three critical care units of KNH and 87 participants were involved. Most of the data were abstracted from the patient records using a predesigned data collection tool. Simple random sampling with replacement was used to select the participants. The data were entered into Microsoft Excel 2010 and analyzed using STATA version 13.0. Descriptive and inferential analyses were conducted and results summarized in tables and charts. The p-value was set at 0.05. Results: The prevalence of DRPs among patients admitted in the ICU of KNH was 59.77 Percent. The major different types of DRPs and causes identified in the study are high dosage (5.75%), adverse reactions (6.9%), needs additional drug therapy (16.1%), drug interactions (19.54%) and noncompliance (26.44%). There was a significant association of drug therapy problems with co-morbidities (p=0.013) and class of drugs (p=0.010), anticonvulsants (p=0.02), antimicrobials (p=0.010), polypharmacy (p=0.001), and multiple prescribers (p=0.01). Conclusion: The prevalence of DRPs was high. Polypharmacy, multiple prescribers and renal problems were independent predictors of DRPs. Recommendation: Compliance to medicines among patients in critical care unit should be enhanced. The causes of non-adherence should be investigated and addressed.