Medication review in inpatients at cardiology clinic / Prehodnotenie terapie u hospitalizovaných pacientov na kardiologickej klinike

This study deals with effect of hospital pharmacist on solving drug-related problems (DRP) in inpatients. The study was carried out as a prospective 5-week study at the Cardiology Clinic, Teaching Hospital, Nitra. The study group included 73 inpatients. Pharmacotherapy of each patient was analysed for DRP within 24-48 h after admission. Information on patients was collected from electronic database, medical reports, communication with attending doctors and ward rounds. Patients’ age, medical history, diagnoses, medication prescribed during hospitalisation and laboratory test results were assessed for further pharmacotherapy rationalisation. Pharmaceutical Care Network Europe (PCNE) classification scheme for DRP V6.2 was used to characterise DRP. There were 36 DRP identified in 37% inpatients (n = 27). The most frequent causes of DRP were dose-related (n = 13; 26%) and use