title: Assessment of clinical pharmacist interventions in drug therapy in patients with diabetes mellitus in a tertiary care teaching hospital.
abstract: OBJECTIVE
  To assess the impact of clinical pharmacist interventions in drug therapy in hospitalized patients with diabetes mellitus.
  
  
  METHODS
  A Prospective interventional study was carried out in the medicine wards of a tertiary care teaching hospital over a period of 10 months from September 2013 to June 2014. The drug therapy details of the patients were collected from inpatient case records in the respective clinical wards. Clinical pharmacist reviewed the drug therapy, identified the drug related problems during ward rounds and discussed with the physicians and suitable suggestions was provided which had been documented.
  
  
  RESULTS
  A total of 189 drug therapy problems were identified from 151 patient case records. The number of drug related problems was found to more in males than females. Drug related problems were commonly seen in patients aged between 61 and 70 years of age. The most common drug related problems was found to be drug use without indication (17.98%) followed by improper drug selection (16.40%). The most frequent suggestions by the clinical pharmacist were on cessation of drug (30.68%). The acceptance rate of suggestions and the changes in drug therapy was found to be high (58.20%). The majority of the level of significance of drug related problems was seen to have moderate significance in grade.
  
  
  CONCLUSIONS
  Involvement of clinical pharmacist as a member of healthcare team during ward rounds in hospitalized patients with diabetes mellitus helps in identification and prevention of drug related problems which will helps to rationalize drug therapy, achieve better therapeutic outcomes and improved patient care.
authors.affiliation: Department of Pharmacy Practice, NGSM Institute of Pharmaceutical Sciences, Paneer, Mangalore, Karnataka, India. Electronic address: javedh.shareef@gmail.com.
authors.forename: Javedh
authors.initials: J
authors.lastname: Shareef
authors.affiliation: NGSM Institute of Pharmaceutical Sciences, Paneer, Mangalore, Karnataka, India. Electronic address: Jennifer_pharma@yahoo.co.in.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fernandes
authors.affiliation: Department of General Medicine, KS Hegde Medical Academy & Hospital, Deralakatte, Mangalore, Karnataka, India. Electronic address: bl_samaga@yahoo.com.
authors.forename: Laxminarayana
authors.initials: L
authors.lastname: Samaga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000075202:Contraindications; D003920:Diabetes Mellitus / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010595:Pharmacists; D062606:Tertiary Care Centers; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents
keywords: Clinical pharmacist; Diabetes mellitus; Drug related problems; Interventions