medication adherence.

The role of a clinical pharmacist is to maximize the clinical effects of medicines by ensuring the selection of the most effective drugs for each patient, minimizing adverse drug events by monitoring the drug therapy course of the patient and improving the patient’s adherence with the drugs. To implement the clinical pharmacist activities in identifying drug therapy problems and improving medication adherence for a better patient care. The prospective observational study was conducted over a period of 6 months. The necessary data was collected from in-patient case notes, treatment charts, interview with patients or patient care givers and nursing staff. The collected data was analyzed to determine the patient drug therapy problems. This study was conducted in a tertiary care hospital for a period of 6 months. A total of 112 patients drug therapy were followed during the six months study period out of which 95 patients had drug therapy problems (DTPs). A total of 182 DTPs were identified in 95 patients, the frequency of DTPs was 1.9 percent per patient. Among 182 DTPs 102 (56%) were identified in males and 80 (43%) were identified in females. The identified DTPs are Adverse drug reactions 4 (2.19%), Interactions 118 (64.84%), Drug selection 56 (30.77%), Drug use 3 (1.65%), Monitoring 1 (0.55%) and Patient/Provider 12 (35.29%). In our study we have showed the importance of clinical pharmacy services in identifying drug therapy problems, so that they can be minimized to decrease the chances of morbid condition and improve better patient care.