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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
Tue Feb 10 2026
Journal Name
Journal Of Baghdad College Of Dentistry
Oral manifestation biochemical and IgA analysis of saliva in hyperthyroid (Grave’s disease) patients(Comparative study)
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Background: Hyperthyroidism occurs due to over production of thyroid hormones, one types of hyperthyroidism was Graves, disease. Hyperthyroidism is characterized by high level of serum thyroxin, triiodothyronine and low level of thyroid stimulated hormones. Material and Methods: fifty two hyperthyroid patients, thirty patients under treatment with carbimazole and other twenty two patients under treatment with radioactive iodine, and sixty healthy control group. The average salivary flow rate was calculated as ml/5mint.The concentration of calcium, potassium, and total protein were determined in the salivary supernatant sample. This is done through different biochemical tests. Determination of salivary IgA is done by ELIZA. Results: The most

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Publication Date
Fri Feb 01 2019
Journal Name
Indian Journal Of Public Health Research
Determination of Glucagon-Like Peptide-1 and Dipeptidyl Peptidase-4 Levels in Diabetic Nephropathy Patients
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Publication Date
Sun Jan 01 2017
Journal Name
Disease Markers
Genotyping of<i> IL-4</i> −590 (C&gt;T) Gene in Iraqi Asthma Patients
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This study is the first investigation in Iraq dealing with genotyping of IL-4 −590 (C>T) gene, especially in Iraqi patients with asthma. We studied forty-eight blood samples collected from patients with asthma and compared with age-matched 25 healthy individuals as controls. The polymorphism results of IL-4 −590 (C>T) gene by using amplification refractory mutation system (ARMS-PCR) showed the presence of C and T alleles and three genotypes (CC, CT, and TT). Interestingly the frequency of C allele and CC genotype was higher in patients with asthma in comparison with the same allele and geno

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Publication Date
Thu Jan 01 2015
Journal Name
Journal Of Biotechnology Research Center
Evaluation of anti Epstien-Barr Virus antibodies in female patients with autoimmune hepatitis type-1
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Epstein-Barr Virus (EBV) infection is associated with broad spectrum of clinical manifestationsdepending on the immune status of the host, To analyze their possible role in the complication ofautoimmune hepatitis, we investigated (30) female patients with autoimmune hepatitis type-1 of(10-40)years and 25 healthy female of same ages(control groups). Both groups were carried outto measure the levels of EBV-CA IgM, IgG Ab, EBV-EA IgM, IgG Ab, and EBV-NA IgM, IgGAb using indirect immunoflourescent assay (IFAT).The prevalence of EBV-CA IgM, IgG Ab were(10%,20%) and EBV-EA IgM, IgG Ab were (10% and20%) respectively, while the prevalence ofEBV-NA IgG Ab was( 3.33%) and there are no prevalence of EBV-NA IgM Ab. There weresignificant differences (P

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Publication Date
Fri Jan 20 2023
Journal Name
Ibn Al-haitham Journal For Pure And Applied Sciences
Evaluation of Osteocalcin and Some Biochemical Marker in Diabetes Mellitus Iraqi Women's patients with Osteoporosis
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Diabetes mellitus is a set of metabolic diseases, the most prevalent of which is chronic hyperglycemia. The culprits include insulin synthesis, insulin action, or both. Osteoporosis is a progressive systemic skeletal disorder defined by decreased bone mass and micro architectural degeneration of bone tissue, resulting in increased bone fragility and fracture risk, according to the World Health Organization (WHO). The degree of Nervosa damage determines how much a diabetic patient's body has been compromised. The current study's goal is an estimation: Age, BMI, FBS, HbA1C, D3, ALP, Ca, P, and Osteocalcin in Iraqi T2DM Women's patients with and without Osteoporosis. Three vitamins are required for Osteocalcin biosynthesis: vitamin K for Gla f

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Publication Date
Mon Apr 01 2019
Journal Name
Biochemical And Cellular Archives
Prevalence of Hbv, Hcv and Hiv-1, 2 infections among patients in Saladin governorate, Iraq
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Hepatitis B and Hepatitis C viruses are the major health problem in the worldwide. In the Middle East, the prevalence of HBV in general population with the chronic infectionsis 2-5%,whereas the prevalence of HCV is about 1% in Arabian Gulf countries. World Health Organization (WHO) revealed that the risks of HBV and HCV transmissionas well as human immunodeficiency virus (HIV) through the transfusion of contaminated blood and blood products is high, because of the fragility of health services in these countries. Several viral diseases are transportby different modes like bloodtransfusion, sexual contact, and unsafe injections. The mostcommon blood-transmitted viruses are hepatitis B virus(HBV), hepatitis C virus (HCV) and humanimmunodeficie

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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Evaluation of Nurses’ Practices Concerning Isolation Techniques for Adult Leukemic Patients in Baghdad Teaching Hospitals
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Objective: To evaluate nurses' practices concerning isolation techniques for Adult Leukemic Patients (ALP).
Methodology: A descriptive study was carried out at the isolation rooms at leukemic wards in Baghdad Teaching
Hospitals, starting from Jan. 27th 2008 up to the 27th of Apr. 2008. To achieve the objectives of study, a non-probability
"purposive" sample of (50) nurse was selected out of four Teaching Hospitals in Baghdad city were selected according
to the criteria of the study sample.
The study instrument consisted of two major parts. It is based on the review of literature. First is concerned with
demographic data for nurses; and the second part is observational tool (checklist) is composed of (83) item. The conte

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Publication Date
Thu Jan 01 2015
Journal Name
Health
Evaluation of Myocardial Performance in Hypertensive Patients with Type 2 Diabetes and Normal Ejection Fraction
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Publication Date
Sun Dec 02 2012
Journal Name
Baghdad Science Journal
Estimation Activity And Partial Purification Of Leucine Amino Peptidase (Lap) In Patients Wiith Diabetic Nephropathy
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Leucine aminopepotidase (LAP)[EC:3.4.11.1] activity has been assayed in (50) serum samples of patients with diabeties naphrophathy D.N (non-insulin dependent diabetic (NIDD) , and (50)serum sample of healthy individuals without any clinically detectable diseases have been as control group. The aim of this study is to measure leucine aminopeptidase activity and partially purifying the enzyme from sera of patients with diabetes nephropathy The results of this study revealed that Leucine aminopeptidase (LAP) activity of nephropathy patient’s serum shows a high signifiacant increase (p < 0.001) compared to that of the healthy subjects.LAP was purified from the serum of patients with diabetes nephropathy by dialysis and gel filtration (Se

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Publication Date
Thu Aug 27 2020
Journal Name
European Journal Of Ophthalmology
Comparison of corneal epithelial thickness profile in dry eye patients, keratoconus suspect, and healthy eyes
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Purpose:

To compare the corneal epithelial thickness profile in patients with dry eyes and keratoconus suspect with normal healthy eyes.

Methods:

The study involved 120 eyes with an age range from 19 to 30 years. Forty eyes had normal corneal topography and no dry eyes. Forty eyes had dry eyes but had normal corneal topography. The last 40 eyes were keratoconus suspect and had no symptoms or signs of dry eyes.

Results:

Central epithelial thickness was not different statistically for all eyes. ( p-value: 0.1). The superior epithelial thickness was 53.5 µm ±3.1 in the control

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