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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 Oct 30 2023
Journal Name
Iraqi Journal Of Science
Silver nanoparticles synthesized by three species of genus Streptococcus and evaluate their synergistic effects with the oil extracted from Syzygium Aromaticum on some clinical bacterial isolates
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Silver nanoparticles synthesized by different species

Publication Date
Tue Nov 01 2011
Journal Name
Journal Of The Saudi Society Of Dermatology & Dermatologic Surgery
Outbreak of thallium poisoning among Iraqi patients
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KE Sharquie, GA Ibrahim, AA Noaimi, HK Hamudy, Journal of the Saudi Society of Dermatology & Dermatologic Surgery, 2011 - Cited by 16

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Publication Date
Wed Oct 18 2023
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Patients’ Compliance with Essential Hypertension
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Objective:
This study aims to asses the patients' compliance with essential hypertension in respect to antihypertensive
medications, follow-up, dietary pattern and health habits, to identify the associated long-term complications, and
to find out the relationship between patient's compliance, and demographic characteristics such as age, gender,
level of education, and duration of disease.
Methodology:
A descriptive study was carried out in Nasiriyah Teaching Hospital to achieve presented objectives .
Results:
The results of the study revealed that there were a significant association between educational level and total
patient's compliance, a significant association was found between the duration of disease and

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Publication Date
Sun Nov 04 2018
Journal Name
Iraqi National Journal Of Nursing Specialties
Assessment of Patients’ Compliance with Essential Hypertension
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Objective:
This study aims to asses the patients' compliance with essential hypertension in respect to antihypertensive
medications, follow-up, dietary pattern and health habits, to identify the associated long-term complications, and
to find out the relationship between patient's compliance, and demographic characteristics such as age, gender,
level of education, and duration of disease.
Methodology:
A descriptive study was carried out in Nasiriyah Teaching Hospital to achieve presented objectives .
Results:
The results of the study revealed that there were a significant association between educational level and total
patient's compliance, a significant association was found between the duration of disease and

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Publication Date
Mon Feb 04 2019
Journal Name
Journal Of The College Of Education For Women
BUMPINESS IN THE ATMOSPHERE IN IRAQ STUDY IN THE GEOGRAPHY OF CLIMATE
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Bumpiness in the atmosphere is the vertical movement of air, whether
upward or downward movement and the bumpiness is accompanied by areas
of unrest in the air and wind. And contribute to each of the coups thermal
fronts, wind, wind and thunderstorms. Moreover, bumpiness is net of the
reasons that lead to circumstances is appropriate to cut the wind, and this
contributes to the formation of bumpiness in the atmosphere. The study found
that the noon of the times, which is expected to occur where clear-air
bumpiness during flights because of the warmth of the earth's surface. The
study found increased incidence of air hole during the summer, especially
July, due to increased incidence of coup surface, while the s

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Publication Date
Thu May 10 2018
Journal Name
Global Journal Of Health Science; Issn 1916-9736 E-issn 1916-9744
Effects of Biological and Non Biological Agents (Disease Modifying Antirheumatic Drugs) on Bone Mineral Density in a Sample of Rheumatoid Arthritis Patients
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Background: Osteoporosis is an extra-articular complication of rheumatoid arthritis that results in increased risk of fractures and associated morbidity, mortality, and healthcare costs. Objective: To evaluate changes in bone mineral density in a sample of rheumatoid arthritis (RA) patients on biological (anti tumor necrosis factor (TNF) alpha) and non-biological agent disease modifying antirheumatic drugs (DMARDs). Patients and Methods: A cross sectional study enrolled 60 RA patients diagnosed by rheumatologist according to the 2010 American College of Rheumatology/European League Against Rheumatism (2010 ACR/EULAR) classification criteria for RA. Thirty patient on biological agent (anti TNF alpha) and 30 patient on non-biological agent (D

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Publication Date
Sat Sep 15 2018
Journal Name
Journal Of Baghdad College Of Dentistry
Evaluation of Hematocrit Level, Red Blood Cells and White Blood Cells Counts in Blood from Patients with Different Severities of Periodontal Diseases
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Background: Anemia of chronic disease (ACD) occurs in the presence of chronic infection, inflammatory conditions or neoplastic conditions despite of adequate iron and vitamins storage. Gingivitis is the inflammation of the gingiva, periodontitis is the inflammation in the periodontium that extend deeper with loss of connective tissue attachment and supporting bone. The main pathogenesis of periodontal diseases and ACD is immune activation. Aims of study: Determine and compare the clinical periodontal parameters (plaque index (PLI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL)). Evaluate the hematocrit (Hct) level, red blood cells (RBCs) count and white blood cells (WBCs) c

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Publication Date
Thu Jun 30 2016
Journal Name
Al-kindy College Medical Journal
Prevalence of bacteria isolated from patients with burn infection at a burn hospital in Baghdad and study of their antimicrobial susceptibility patterns
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Background: The skin functions as a barrier to the external environment, damage to this barrier following a burn disrupts the innate immune system and increases susceptibility to bacterial infection. Objective: This study was carried out to determine the bacterial isolates and study their antimicrobial susceptibility in burned wound infections at one burn's hospital in Baghdad.Type of study:Cross-sectional study.Methods: The bacteria were identified at species level by using Analytic Profile Index (API) system and The antimicrobial susceptibility test was performed according to Kirby-Bauer (disk diffusion) technique.Results: Over a period of one year (from October 2014 to October 2015). Out of 848 patients with different degrees of burns

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Publication Date
Wed Dec 30 2020
Journal Name
Iraqi Journal Of Pharmaceutical Sciences ( P-issn 1683 - 3597 E-issn 2521 - 3512)
Levothyroxine Therapy Adequacy, Dose Estimation and Vitamin D Effect Assessment in a Sample of Iraqi Female Patients with Different Causes of Hypothyroidism
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Exogenous levothyroxine dose modulation and euthyroidism achievement is a persistent challenge in clinical settings. This study strives to assess the adequacy of treatment and identify the patients’ factors that can be used to estimate the euthyroid levothyroxine dose. A secondary objective was to assess vitamin D supplementation impact on thyroid status.

A review of a prospectively collected information from 142 female patients from Baghdad Center of Nuclear Medicine from June 2019 until March 2020 who were receiving levothyroxine for different causes was done. After a follow-up period, the patients’ thyroid tests were assessed and the euthyroid doses for each cause category were statistically analyzed. Thyroid function was

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Publication Date
Sat Jul 20 2024
Journal Name
Al-rafidain Journal Of Medical Sciences ( Issn 2789-3219 )
Gender Distribution of Coronary Artery Calcium Score and Degree of Stenosis Assessed by Computed Tomography Angiography in Iraqi Patients with Chest Pain
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Background: Sex variations in coronary artery disease (CAD) are well documented. However, sex differences in coronary artery calcium (CAC) and its role in the detection of coronary artery stenosis remain controversial. Objective: To assess the impact of sex variation on coronary artery calcification and its efficacy in predicting coronary artery stenosis. Methods: This is a cross-sectional observational study including 230 consecutive patients with suspected CAD (120 men and 110 women) referred for coronary computed tomography angiography (CCTA). The study analyzed sex-based differences in the sensitivity and specificity of coronary artery calcification (CAC) for detecting moderate to severe stenosis across various coronary arteries

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