Drug-related problems among hospitalized patients with cardiovascular diseases in China: a retrospective study

Background Data are lacking on the baseline characteristics of drug-related problems (DRPs) and the impact of clinical pharmacy activities among patients with cardiovascular diseases (CVDs) in China. This study aimed to characterize the features of DRPs in patients with CVDs and to identify factors associated with the presence of multiple DRPs. Methods A retrospective study was conducted among hospitalized patients with CVDs at a tertiary hospital in China from July 2022 to February 2024. During the study period, clinical pharmacists reviewed medication orders, documented DRPs and interventions, and classified DRPs according to the Pharmaceutical Care Network Europe (PCNE) Classification version 9.1. Baseline characteristics were evaluated, and patients were stratified into two groups based on the number of DRPs: those with a single DRP and those with multiple DRPs. Multivariable logistic regression analysis was performed to identify factors associated with the presence of multiple DRPs. Results In total, 312 interventions associated with DRPs were recorded for 213 hospitalized patients with CVDs, and 30.52% of the patients with at least one DRP experienced multiple DRPs. The most frequent category of DRPs was “treatment effectiveness (P1)”, whereas the most common cause was “drug selection (C1)”. The most common intervention was “drug started (I3.6)”. Of all recommendations made, 75.00% were accepted and implemented (A1.1) and a further 13.14% were accepted but not implemented (A1.3), yielding an overall acceptance rate of 88.14% (A1). Multivariable analysis revealed that eGFR < 45 mL/min/1.73 m² (OR = 2.280, 95% CI: 1.035-5.020, P = 0.041) and hospital stay 7 days (OR = 2.615, 95% CI: 1.148-5.955, P =0.022) were significantly associated with the presence of multiple DRPs. Conclusion Clinical pharmacists identified a considerable number of guideline-discordant medication decisions in hospitalized patients with CVDs, and prescribers accepted most of the resulting recommendations.