Investigating the Frequency and Nature of Medication-Related Problems in the Women’s Health Unit of an Australian Tertiary Teaching Hospital

Abstract

Background: Despite the large burden medication-related morbidity and mortality places on the Australian health care system, there is little known about the extent of this problem in a women’s health (obstetric and gynecology) setting. Objective: Determine the frequency and nature of medication-related problems (MRPs) occurring in a women’s health unit (WHU) of an Australian teaching hospital. Methods: A prospective audit of consecutive cases of patients treated in the WHU at a tertiary-level teaching hospital was undertaken by a clinical pharmacist over a 5-week period. Data collected included the following: patient characteristics, type of MRP (using a modified version of the Hepler-Strand classification system), medication involved (according to the World Health Organisation Anatomical Therapeutic Chemical classification system), and clinical significance (using a 2-level severity index). Results: A total of 454 potential MRPs were identified over the 5-week period among 241 patients. A total of 39 MRPs (8.6%) identified were deemed to be of moderate/high clinical significance. The highest number of MRPs (221; 49%) was identified among women admitted following a cesarean delivery, with 83 of 85 women in this group experiencing at least 1 MRP. Additional factors associated with an increased likelihood of patients experiencing a MRP included increased age, length of hospital stay, and number of regular medications taken prior to and during admission (P < 0.05). Conclusion: The widespread nature of identified MRPs in this setting suggests that various approaches to minimizing these problems and mitigating the associated burden on the health care system are warranted.