Collaboration between clinical pharmacists and physicians to manage drug-related problems in an adult hematopoietic stem cell transplantation unit

IntroductionThis study aimed to determine drug-related problems and identify potential solution in collaboration with clinical pharmacists and specialist physicians at an adult hematopoietic stem cell transplantation unit in Türkiye.MethodsThis is a prospective observational study that included patients with autologous and allogeneic HSCT (Hematopoietic Stem cell Transplantation) admitted to a university hospital HSCT unit in Türkiye due to the disease or complications between June 2023 and January 2024. Drug-related problems (DRPs) were identified during a comprehensive medication review performed by a single clinical pharmacist (specialist trainee) supervised by a senior clinical pharmacist, using the Turkish version of the v.9.1 Pharmaceutical Care Network Europe (PCNE) classification. The potential DRPs were reported to the physicians to discuss their agreement on the possible solutions. The number of DRPs, agreement rate of the solutions and status of interventions were recorded.ResultsThe study enrolled 66 adult patients with a median age of 54.5 years (54.5% male). A total of 156 potential DRPs were identified among the patients at HSCTU with an average of 2.4 DRPs per patient. The proportion of patients experiencing at least one DRP was 89% in the autologous HSCT group and 97% in the allogeneic HSCT group. Patients with allogeneic HSCT experienced a significantly higher number of DRPs compared to those with autologous HSCT. Among DRPs, drug-drug interactions (DDIs) were common (56.0%). The majority of the recommendations made by the clinical pharmacist in training were accepted by the physicians (86.5%). Overall, 84.0% of DRPs were solved in collaboration with clinical pharmacists and physicians.ConclusionsDDIs were common DRPs among patients with HSCT. Most of the clinical pharmacists' recommendations were accepted. A substantial number of potential DRPs were effectively resolved through direct collaboration between the clinical pharmacist and physicians.