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The Role of Clinical Pharmacist in Reducing Drug Related Problems in Hemodialysis Patients
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Abstract

Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient.  Identification and classification of drug related problems and discussing them with the health care providers.  Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical Care Network Europe classification, an interventional phase to increase the awareness of patients and the nephrologists about those problems and proposing a proper solution for each one.  The main drug related problems was related to the effect of drug treatment being not optimal in 58.7%, followed by no effect in 17.8%, and least for unrelated symptoms or indications in 4.8%; causes were inappropriate combination and patients taking less drug than prescribed (both 17.4%), followed by no/or incomplete drug treatment in spite of existing indication in 12.2%, drug without indication in 10.4%. Erythropoietin and calcium were the most frequently drugs with problems. Acceptance and full implementation were observed in 34.3%, while half of the drug related problems had unknown implementation (51.3%). There were significant numbers of drug related problems among Iraqi patients on hemodialysis, the use of erythropoietin, calcium carbonate and sevelamer  was responsible for most of inappropriate combinations. Physicians and clinical pharmacist cooperation was excellent.

Keywords: Drug related problems, Hemodialysis, Clinical pharmacist.

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Publication Date
Mon Mar 31 2025
Journal Name
Romanian Medical Journal
Amylase and lipase roles as prognostic indicators in patients with diabetic foot
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Background. Diabetes mellitus (DM) is a prevalent disease that, if not appropriately managed, can lead to a variety of problems, including diabetic foot. Glycated hemoglobin A1c (HbA1c), FBS, amylase, and lipase are important diabetic management indicators now employed as diagnostic tests. Objective. This study aimed to evaluate the value of amylase and lipase as predictive markers in patients with diabetic foot. Patients and methods. This study included 50 patients who reported to Baghdad Hospital with diabetic feet between November 2023 and February 2025. All patients had their HbA1c, amylase, lipase, and FBS levels tested. Means, independent t-tests, and the F-test were used in the statistical analysis. Results. The study evaluat

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Publication Date
Fri Jan 19 2024
Journal Name
Baghdad Science Journal
GRHPR gene variations in Iraqi patients infected with calcium oxalate kidney stones
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      The alterations in glyoxylate reductase and hydroxy-pyruvate reductase concentrations in the sera and the genetic alterations associated with calcium oxalate kidney stones in Iraqi patients were not studied previously so this study aimed to focus on these points. This study included 80 subjects; they were 50 patients with calcium oxalate stones compared to 30 apparently healthy controls. Biochemical investigations for kidney functions (creatinine, urea, and uric acid), were performed on the sera of both groups. Also, complete blood count, random blood sugar, and blood group tests. Furthermore, urine had been collected for General Urine Examination to visualize oxalate crystals in the urine of the patient. Also, the GRHPR

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Publication Date
Fri Jul 22 2022
Journal Name
Biochemical And Cellular Archive
HEPATITIS B VIRUS GENOTYPES IN IRAQI PATIENTS WITH CHRONIC HEPATITIS B INFECTION
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Hepatitis B virus (HBV) infection is a serious disease of the liver and signifies a major worldwide health concern. HBV Genotyping is vital for further epidemiological study, predicting the disease outcome and response to treatment. The current study aimed to determine hepatitis B virus genotypes in patients with chronic hepatitis B, and to validate possible associations with the baseline characteristics of the disease. A total of 90 patients with chronic hepatitis B infection were enrolled in this study. Liver function tests, hepatitis B virus markers and DNA viral load were done using routine standardized procedures. HBV genotyping was performed using real time PCR. Genotype D was the most predominant in 64 (71.1%) of samples, while

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Publication Date
Sun Jan 01 2023
Journal Name
Česká A Slovenská Farmacie
Hyperferritinemia as a factor associated with poor prognosis in COVID-19 patients
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Worldwide, hundreds of millions of people have been infected with COVID-19 since December 2019; however, about 20% or less developed severe symptoms. The main aim of the current study was to  assess  the  relationship  between  the  severity of Covid-19 and different clinical and laboratory parameters. A total number of 466 Arabs have willingly joined this prospective cohort. Out of the total number, 297 subjects (63.7%) had negative COVID-19 tests, and thus, they were recruited as controls, while 169 subjects (36.3%) who tested positive for COVID-19 were enrolled as cases. Out of the total number of COVID-19 patients, 127 (75.15%) presented with mild symptoms, and 42 (24.85%) had severe symptoms. The age range for the partic

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Publication Date
Sun Mar 04 2012
Journal Name
Baghdad Science Journal
C-Reactive Protein and Cholesterol level In Male Type 2 Diabetic Patients.
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Elevated C-Reactive Protein (CRP) level in serum is a risk factor for type 2 diabetes ,this relationship is likely to be the cause it means elevated CRP leads to T2D in future . Our objective was to examine CRP in male Type 2 Diabetes(T2D) patients in different age ,we studied 120 male subjects divided to two groups according to their age. First group A age (31 - 40) year old ,60 person )30 control & 30 T2D patients(,3 person for each same age: second group B age (41 – 50) years old ,60 person )30 control & 30 T2D patients(,3 person for each same age. We examined blood sugar ,cholesterol and CRP in each group. and we toke the mean of samples in the same age in each data in all the 4 groups. Our data shows that CRP

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Publication Date
Tue Jan 01 2019
Journal Name
Journal Of Clinical And Diagnostic Research
Thiopurine S-Methyltransferase Polymorphism in Iraqi Paediatric Patients with Acute Lymphoblastic Leukaemia
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Publication Date
Fri Jan 01 2010
Journal Name
Iraqi Journal Of Biotechnology
BIOCHEMICAL STUDY ON SUPEROXIDE DISMUTASE ENZYME IN PATIENTS WITH DIFFERENT BRAIN TUMORS
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The aim of the current study is to in evaluate the role of SOD activity in the previously reported oxidative stress in our laboratory(1), in the patients with different brain tumors. SOD activity was assayed according to riboflavin/NBT method and its specific activity was calculated in patients with benign and malignant brain tumors and control. Moreover the specific activity was compared in these samples according to gender and the occurrence of disease.Non significant elevation (P > 0.05) in SOD specific activity was observed in tissue of malignant tumors in comparison to that of in benign brain tumors. While a highly significant decrease (P < 0.001) of the specific activity was found in sera of malignant patients group in comparison to t

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Publication Date
Sat Dec 01 2018
Journal Name
Annals Of Medicine And Surgery
Plasma d-dimer level correlated with advanced breast carcinoma in female patients
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Publication Date
Tue Aug 23 2022
Journal Name
International Journal Of Health Sciences
Association between periostin and bone minerals in osteoporosis and osteopenia Iraqi patients
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Background: osteoporosis is characterized by a reduction in bone mineral density, skeletal microstructure breakdown, increased bone fragility, and fracture susceptibility. Osteopenia is the preceding step to osteoporosis because it causes a decrease in bone mass, osteoporosis reduces a person's quality of life. Periostin (encoded by Postn), its name is derived from the fact that it was first detected in periosteal osteocytes and osteoblasts. Periostin deficiency has been linked to osteoporosis and weak bones. Study objectives: The purpose of this study was to determine periostin levels in serum of Iraqi patients with osteoporosis and osteopenia, and it is also possible to consider periostin as a diagnostic factor to follow the progression o

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Publication Date
Mon Apr 01 2013
Journal Name
Medical Journal Of Babylon
Interleukin-33(IL-33) in Iraqi’s Rheumatoid Arthritis Patients Prone to Atherosclerosis
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The aim of this study is to determine serum IL-33 levels and atherogenic index of plasma (AIP) .Forty patients with moderate activity of rheumatoid arthritis (RA) and forty healthy individuals as control group were enrolled in this study, age (25-45) years. Disease activity was assessed in patients by erythrocyte sedimentation rate (ESR),C-reactive protein (CRP) and rheumatoid factor(RF) .Also lipid profile(cholesterol TC, triglyceride TG, low density lipoprotein LDL-C, very low density lipoprotein VLDL and high density lipoprotein HDL-C), AIP, and IL-33 were determined in all subjects. The results revealed a significant increase in ESR,CRP and RF , TG, VLDL,AIP and IL-33,while is a significant decrease in HDL concentration in patients gr

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