ผลของการแทรกแซงโดยเภสัชกรในการป้องกันปัญหาจากการใช้ยา ที่เกี่ยวข้องกับการสั่งจ่ายวัคซีนป้องกันโรคพิษสุนัขบ้าแบบหลังสัมผัสโรค ที่ห้องฉุกเฉินโรงพยาบาลศรีนครินทร์

Rindawan Phankien; Lukkana   Matvises; Sirinya  Chantaramethakun; Thapanawong  Mitsungnern

doi:10.64960/srimedj.v41i3.269815

Authors

Rindawan Phankien Department of Pharmacy Service, Faculty of Medicine, Khon Kaen University, Thailand 40002
Lukkana Matvises Department of Pharmacy Service, Faculty of Medicine, Khon Kaen University, Thailand 40002
Sirinya Chantaramethakun Department of Pharmacy Service, Faculty of Medicine, Khon Kaen University, Thailand 40002
Thapanawong Mitsungnern Department of Emergency Medicine, Faculty of Medicine, Khon Kaen University, Thailand 40002

DOI:

https://doi.org/10.64960/srimedj.v41i3.269815

Keywords:

pharmacist, drug-related problems, rabies vaccine, post-exposure prophylaxis, emergency room

Abstract

Background and objectives: Rabies is a disease with a 100% fatality rate because of incurable disease. Appropriate regimens and the timing of vaccine administration are critical to saving lives. Pharmacists are responsible for overseeing all aspects of medication management to ensure safe delivery to patients. This study investigated the impact of pharmacist intervention on the prevention of drug-related problems (DRPs) associated with prescribing post-exposure prophylaxis, including rabies vaccines and immunoglobulins. The research aims to identify the types and frequency of DRPs and to evaluate the outcomes of pharmacist interventions.

Methods: This was a retrospective observational study. Inclusion criteria were patients who received rabies post-exposure prophylaxis (PEP) at the emergency room, Srinagarind Hospital, from January 1, 2022, to December 31, 2024. Data was collected from the hospital database, and DRPs were classified according to Heple and Strand classification.

Results: A total of 3,846 patients (3,977 visits) were included. Overall, 401 DRPs were identified, with improper drug selection as the most common type (60.8%), followed by drug use without indication (17.5%) and overdosage (11.5%). The pharmacist intervened in 184 cases with a 100% acceptance rate, resulting in direct cost savings of 126,484.50 THB. There were 217 DRPs without intervention, primarily inappropriate antibiotic selection. The primary cause of DRPs was knowledge/information-related issues.

Conclusions: Pharmacists serve as the checkpoint in screening for potential problems before patients receive their medications. Effective screening and prescription analysis appropriateness by pharmacists may contribute to prevent DRPs, reduc risks, enhance patient safety, and decrease healthcare costs in managing rabies-exposed patients.

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