{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T21:03:17Z","timestamp":1792184597094,"version":"4.4.0"},"reference-count":47,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2020,4,23]],"date-time":"2020-04-23T00:00:00Z","timestamp":1587600000000},"content-version":"unspecified","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,3,20]]},"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the incidence and types of drug-related problems (DRP) in a general teaching hospital and to evaluate the acceptability of pharmaceutical interventions by the medical team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective cohort study during 2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Conducted in a Brazilian University Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The patient cohort consisted of 9303 patients with a total of 12\u2009286 hospitalisation episodes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measures<\/jats:title>\n                    <jats:p>DRP detected by pharmacists\u2019 review of 100% medication orders using Pharmaceutical Care Network Europe 6.2 classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with a mean age of 52.6\u00b117.7 years and 50.9% females. A total of 3373 DRP in 1903 hospital episodes were identified, corresponding to a cumulative incidence of 15.5%. \u2018Treatment ineffectiveness\u2019 (11.5%) and \u2018Treatment costs\u2019 (5.90%) were the most common DRP and \u2018Drug use process\u2019 (18.4%) and \u2018Treatment duration\u2019 (31.0%) the main causes of DRP. The medicines involved most often involved in DRP were anti-infectives (36.0%), mainly cephalosporins (20.2%), antiulcer (38.6%), analgesics\/antipyretics (61.2%), propulsives (51.2%), opioids (38.5%) and antiemetics (57.4%). From 1939 pharmaceutical interventions, at least, 21.4% were not approved by the medical team.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DRP detected by 100% medication order review by hospital pharmacists occur in a significant proportion of hospital episodes, the most frequent being related to treatment effectiveness and treatment costs. The medications mostly involved were cephalosporins, penicillins, antidyspeptics, analgesics, antipyretics, opioids and antiemetics. Pharmaceutical interventions had low acceptability by the medical staff.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-035848","type":"journal-article","created":{"date-parts":[[2020,4,24]],"date-time":"2020-04-24T04:16:22Z","timestamp":1587701782000},"page":"e035848","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Incidence, types and acceptability of pharmaceutical interventions about drug related problems in a general hospital: an open prospective cohort"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5223-5061","authenticated-orcid":false,"given":"Valdjane","family":"Saldanha","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Postgraduate Program in Pharmaceutical Sciences, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rand","family":"Randall Martins","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Iasmin Vieira Cunha","family":"Lima","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Postgraduate Program in Pharmaceutical Sciences, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivonete","family":"Batista de Araujo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Gouveia Oliveira","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Centro de Ci\u00eancias da Sa\u00fade, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,4,23]]},"reference":[{"key":"2025121223370950000_10.4.e035848.1","unstructured":"PCNE Pharmaceutical Care Network Europe . The definition of drug-related problems. Available: https:\/\/www.pcne.org\/upload\/files\/11_PCNE_classification_V6-2.pdf. (2009) [Accessed 7 Feb 2020]."},{"key":"2025121223370950000_10.4.e035848.2","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s11096-017-0581-9","article-title":"The scope of drug-related problems in the home care setting","volume":"40","author":"Meyer-Massetti","year":"2018","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.3","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s11096-014-0063-2","article-title":"Drug-Related problems in institutionalized, polymedicated elderly patients: opportunities for pharmacist intervention","volume":"37","author":"Silva","year":"2015","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12913-019-4114-1","article-title":"Qualitative and quantitative research of medication review and drug-related problems in Hungarian community pharmacies: a pilot study","volume":"19","author":"Szilvay","year":"2019","journal-title":"BMC Health Serv Res"},{"key":"2025121223370950000_10.4.e035848.5","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s40780-018-0125-z","article-title":"Potential drug-related problems detected by routine pharmaceutical interventions: safety and economic contributions made by hospital pharmacists in Japan","volume":"4","author":"Tasaka","year":"2018","journal-title":"J Pharm Health Care Sci"},{"key":"2025121223370950000_10.4.e035848.6","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1007\/s11096-017-0504-9","article-title":"Assessment of drug-related problems in pediatric ward of Zewditu Memorial referral Hospital, Addis Ababa, Ethiopia","volume":"39","author":"Birarra","year":"2017","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.7","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s11096-018-0777-7","article-title":"Identify and categorize drug-related problems in hospitalized surgical patients in China","volume":"41","author":"Qu","year":"2019","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.8","first-page":"9","article-title":"Patient risk factors for developing a drug-related problem in a cardiology ward","volume":"11","author":"Urbina","year":"2015","journal-title":"Ther Clin Risk Manag"},{"key":"2025121223370950000_10.4.e035848.9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0210779","article-title":"Analysis of clinical pharmacist interventions in the neurology unit of a Brazilian tertiary teaching hospital","volume":"14","author":"Rodrigues","year":"2019","journal-title":"PLoS One"},{"key":"2025121223370950000_10.4.e035848.10","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.12293"},{"key":"2025121223370950000_10.4.e035848.11","doi-asserted-by":"crossref","first-page":"44","DOI":"10.4103\/2230-8229.149590","article-title":"Admissions for drug-related problems at the emergency department of a university hospital in the Kingdom of Saudi Arabia","volume":"22","author":"Alghamdy","year":"2015","journal-title":"J Family Community Med"},{"key":"2025121223370950000_10.4.e035848.12","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1007\/s11096-018-0733-6","article-title":"Impact of pharmacist interventions on clinical outcome and cost avoidance in a university teaching hospital","volume":"40","author":"Jourdan","year":"2018","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.13","doi-asserted-by":"publisher","DOI":"10.4338\/ACI-2014-04-RA-0040"},{"key":"2025121223370950000_10.4.e035848.14","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.gaceta.2018.01.002","article-title":"[Analysis of drug-related problems in a tertiary university hospital in Barcelona (Spain)]","volume":"33","author":"Ferr\u00e1ndez","year":"2019","journal-title":"Gac Sanit"},{"key":"2025121223370950000_10.4.e035848.15","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006376"},{"key":"2025121223370950000_10.4.e035848.16","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1007\/s11096-018-0617-9","article-title":"Pharmacists in general practice: a focus on drug-related problems","volume":"40","author":"Benson","year":"2018","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.17","first-page":"111","article-title":"[Adverse drug reactions and prescription errors: morbi-mortality]","volume":"73","author":"Chaio","year":"2013","journal-title":"Medicina"},{"key":"2025121223370950000_10.4.e035848.18","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-008-9213-8"},{"key":"2025121223370950000_10.4.e035848.19","doi-asserted-by":"crossref","DOI":"10.4414\/smw.2012.13615","article-title":"Drug-related problems and factors influencing acceptance of clinical pharmacologists alerts in a large cohort of neurology inpatients","volume":"142","author":"Taegtmeyer","year":"2012","journal-title":"Swiss Med Wkly"},{"key":"2025121223370950000_10.4.e035848.20","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1007\/s11096-015-0146-8","article-title":"Potential drug-related problems detected by electronic expert support system: physicians' views on clinical relevance","volume":"37","author":"Hammar","year":"2015","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.21","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1007\/s11096-014-9976-z","article-title":"Potential drug related problems detected by electronic expert support system in patients with multi-dose drug dispensing","volume":"36","author":"Tora","year":"2014","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.22","doi-asserted-by":"crossref","DOI":"10.1186\/s12887-019-1499-2","article-title":"Drug related problems in the neonatal intensive care unit: incidence, characterization and clinical relevance","volume":"19","author":"Leopoldino","year":"2019","journal-title":"BMC Pediatr"},{"key":"2025121223370950000_10.4.e035848.23","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1007\/s11096-017-0585-5","article-title":"Drug related problems identified by clinical pharmacist at the internal medicine ward in turkey","volume":"40","author":"Abunahlah","year":"2018","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.24","doi-asserted-by":"crossref","first-page":"505","DOI":"10.2147\/TCRM.S194921","article-title":"Drug-Related problems in patients with rheumatoid arthritis","volume":"15","author":"Ma","year":"2019","journal-title":"Ther Clin Risk Manag"},{"key":"2025121223370950000_10.4.e035848.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2710.2008.00990.x"},{"key":"2025121223370950000_10.4.e035848.26","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-006-9020-z"},{"key":"2025121223370950000_10.4.e035848.27","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-009-9352-6"},{"key":"2025121223370950000_10.4.e035848.28","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1007\/s11096-019-00832-4","article-title":"Characteristic of drug-related problems and pharmacists' interventions in a stroke unit in Thailand","volume":"41","author":"Semcharoen","year":"2019","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.29","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.ejim.2015.05.012","article-title":"Drug-Related problems identification in general internal medicine: the impact and role of the clinical pharmacist and pharmacologist","volume":"26","author":"Guignard","year":"2015","journal-title":"Eur J Intern Med"},{"key":"2025121223370950000_10.4.e035848.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2010.08.017"},{"key":"2025121223370950000_10.4.e035848.31","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1002\/pds.3634","article-title":"Design of a score to identify hospitalized patients at risk of drug-related problems","volume":"23","author":"Urbina","year":"2014","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"2025121223370950000_10.4.e035848.32","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-004-0830-4"},{"key":"2025121223370950000_10.4.e035848.33","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s00391-015-0911-2","article-title":"Prescription errors in geriatric patients can be avoided by means of a computerized physician order entry (CPOE)","volume":"49","author":"Frisse","year":"2016","journal-title":"Z Gerontol Geriatr"},{"key":"2025121223370950000_10.4.e035848.34","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocv135"},{"key":"2025121223370950000_10.4.e035848.35","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.pharma.2015.06.001","article-title":"[Medication errors related to computerized physician order entry at the hospital: Record and analysis over a period of 4 years]","volume":"74","author":"Hellot-Guersing","year":"2016","journal-title":"Ann Pharm Fr"},{"key":"2025121223370950000_10.4.e035848.36","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-012-9724-1"},{"key":"2025121223370950000_10.4.e035848.37","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1007\/s11096-017-0571-y","article-title":"Drug-Related problems identified during geriatric medication review in the community pharmacy","volume":"40","author":"Rhalimi","year":"2018","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.38","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3390\/pharmacy6010021","article-title":"The introduction of a full medication review process in a local Hospital: successes and barriers of a pilot project in the geriatric ward","volume":"6","author":"De Bock","year":"2018","journal-title":"Pharmacy"},{"key":"2025121223370950000_10.4.e035848.39","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1007\/s11096-015-0179-z","article-title":"Demonstrating the clinical pharmacist's activity: validation of an intervention oriented classification system","volume":"37","author":"Maes","year":"2015","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.40","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1111\/ijpp.12481","article-title":"Integration of a clinical pharmacist into a Canadian, urban emergency department: a prospective observational study","volume":"27","author":"Dryden","year":"2019","journal-title":"Int J Pharm Pract"},{"key":"2025121223370950000_10.4.e035848.41","doi-asserted-by":"crossref","first-page":"285","DOI":"10.4103\/2279-042X.192455","article-title":"Detecting and managing drug-related problems in the neurology ward of a tertiary care teaching hospital in Iran: a clinical pharmacist's intervention","volume":"5","author":"Foroughinia","year":"2016","journal-title":"J Res Pharm Pract"},{"key":"2025121223370950000_10.4.e035848.42","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1007\/s11096-019-00796-5","article-title":"Impact of pharmacists' interventions on physicians' decision of a knowledge-based renal dosage adjustment system","volume":"41","author":"Choi","year":"2019","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.43","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1007\/s11096-015-0213-1","article-title":"Analysis of drug-related problems in three departments of a German university hospital","volume":"38","author":"Lenssen","year":"2016","journal-title":"Int J Clin Pharm"},{"key":"2025121223370950000_10.4.e035848.44","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1111\/jcpt.12637","article-title":"Drug-Related problems identified during medication review before and after the introduction of a clinical decision support system","volume":"43","author":"Verdoorn","year":"2018","journal-title":"J Clin Pharm Ther"},{"key":"2025121223370950000_10.4.e035848.45","first-page":"2737","article-title":"Network analysis of drug-related problems in hospitalized patients with hematologic malignancies","volume":"26","author":"Kim","year":"2018","journal-title":"Support Care Cancer"},{"key":"2025121223370950000_10.4.e035848.46","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1111\/jcpt.12473","article-title":"Prevalence of drug-related problems associated with direct oral anticoagulants in hospitalized patients: a multicenter, cross-sectional study","volume":"42","author":"Viprey","year":"2017","journal-title":"J Clin Pharm Ther"},{"key":"2025121223370950000_10.4.e035848.47","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-014-1686-x"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-035848","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:37:24Z","timestamp":1765611444000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-035848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4]]},"references-count":47,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,4,23]]},"published-print":{"date-parts":[[2020,4]]}},"alternative-id":["10.1136\/bmjopen-2019-035848"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-035848","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4]]}}}