Special Issue (May) Online - 2455-3891 Print - 0974-2441 II-Indonesian Conference on Clinical Pharmacy EVALUATION OF THE PHARMACY SUPPORT SYSTEM IN THE DETECTION OF DRUG-RELATED PROBLEMS TRI MURTI ANDAYANI 1 *, FITA RAHMAWATI 1 , RIFKY ROCHMAN 2 , ARRISA DWI NINGRUM 3 1 Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Indonesia. 2 Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Indonesia. 3 Department of Pharmacy, Faculty of Pharmacy, Universitas Gadjah Mada, Indonesia. Email: trimurtia@yahoo.com Received: 18 October 2016, Revised and Accepted: 24 January 2017 ABSTRACT Objective: The efficiency and speed of a system in identifying drug-related problems (DRPs) can support and optimize the performance of pharmacists. The objective of this research was to determine the time of analysis and the number of DRPs’ incidences identified by pharmacists with and without pharmacy support systems (PSS). Methods: The present research was observational with cross-sectional design. The data collection was done prospectively in outpatients at hospital during January 2016. Observations were conducted to the difference between the analysis and the number of DRPs’ incidence identified by the pharmacists with and without the assistance of PSS. The research population was outpatient at a number of hospitals in Yogyakarta. The tools used in this research were PSS which were a clinical information system that can identify potential DRPs and included three main parts, namely, the patients’ profile, drug information, and analysis of DRPs. The identification result of DRPs was consisted of six DRPs categories, i.e., without treatment indication, treatment without indication, ineffective drug, too low dose, too high dose, and undesirable drug reactions. Results: Pharmacists without PSS require faster time to analyze the prescription of outpatients. The time majority spent by pharmacists with PSS in reviewing the patients’ prescription lies in the length of time the patients enter the therapy-related data obtained manually by patients until the warning being displayed and making clinical decision related to the DRPs. The statistical test result using Goodness of fit test and Fisher between categories of DRPs incidences detected by pharmacists with and without the assistance of PPS indicates significant differences (p<0.05). Pharmacists with PSS can detect DRPs that are not detected by the pharmacist without PSS. DRPs mostly identified by pharmacists with the assistance of PSS are drug interactions and improper doses. Improper doses primarily identified in geriatric and pediatric patients’ prescription. Conclusion: Pharmacists with PSS software can detect DRPs that are not detected by pharmacists only. However, pharmacists using the software PSS require a longer time in the identification of DRPs compared to pharmacists without using PSS. Keywords: Pharmacy support systems, Drug-related problems, Outpatients. Research Article INTRODUCTION Drug-related problems (DRPs) are events or circumstances related to drug therapy, which potentially or actually affect clinical outcomes of the patients. DRPs are capable of resulting significant morbidity and mortality and contribute to soaring health costs [1]. Several strategies have been done to prevent drug-related problems, for instance, the evaluation of drug treatment, education of health-care workers or patients, assessing treatment and participation of clinical pharmacists in health professional team. Daily activities in hospital characterized by a high number of patients, very limited time, and speed of services provide unlimited space for evaluating drug therapy [2]. Professional skills of pharmacists in identifying the DRPs cover knowledge not only regarding drug but also evidence-based guidelines and contemporary management of various medical conditions also play a role in the incidence of DRPs. Thereby, that the information technology in treatment management process has been suggested to improve appropriate and safe treatment. The utilization of computerized-based information technology is proven to efficiently assist the pharmacists in identifying potential DRPs [3-6]. Study center and consultation: Industry, management, and pharmacy services of Gadjah Mada University have developed software of clinical information system called Gama pharmacy support system (GPSS), in which this system is able to assess prescriptions in outpatient and provide warning on DRPs potential. GPSS is comprised three main parts, i.e., the patients’ profile, drug information, and DRPs analysis. The presence of such system is expected to assist pharmacists in making clinical decisions associated with patients’ treatment and to prevent DRPs incidences. In the medical technology or intervention, a diagnostic test must be evaluated before being introduced into daily practice. Diagnostic accuracy plays a pivotal role in clinical evaluation [7]. The accuracy of a diagnostic test depends on the sensitivity and specificity. The computation result of GPSS diagnostic value has shown the sensitivity value of 97.2%, specificity of 45.2%, positive predictive value of 66.7%, and negative predictive value of 93.4%. The sensitivity value of 97.2% suggests that pharmacists with the assistance of GPSS are able to detect 95% of patients at risk of potential DRPs. The specificity value of 45.2% shows the capability of pharmacists with the help of GPSS to determine 45.2% of patients not at risk of potential DRPs. Previous research suggests that the safety warning system against drug use should have high sensitivity and specificity, provide clear information, not inhibit the workflow, and facilitate the handling upon warnings in safe and efficient manner [8]. However, there is no practical system that is able to achieve the sensitivity and specificity up to 100% [9]. The current system tends to have high sensitivity but generally low in specificity [10]. The efficiency and speed of a system in identifying DRPs can support and optimize the performance of pharmacists. Hatfield et al. (2014) reports that the implementation of computerized provider order entry system can allocate more time on clinical activities to strengthen clinical © 2017 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ajpcr.2017.v10s2.19497