Effectiveness of a Structured Pharmacist-led Intervention in Improving Pediatric Outpatient Prescribing Quality in a Resource-limited Setting: A Pre–post Study

Objective: The objective is to determine the prevalence and types of drug-related problems (DRPs), identify associated factors, and evaluate the impact of a structured pharmacist-led intervention on prescribing quality in pediatric outpatient care in a resource-limited health system with limited advanced prescribing decision-support. Methods: A pre–post intervention study was conducted from July 2023 to June 2024 at a secondary-level hospital in a lower-middle-income country setting (Vietnam). Two independent cross-sectional prescription samples were obtained using systematic random sampling (323 prescriptions preintervention and 323 postintervention). DRPs were identified using national prescribing frameworks and mapped to the Pharmaceutical Care Network Europe DRP Classification (v9.1). The intervention comprised pharmacist-led educational sessions and the dissemination of drug information bulletins, with ongoing reminders, targeting the most frequent baseline DRPs. Factors associated with DRP occurrence (≥1 DRP per prescription) were examined using logistic regression; pre–post comparisons used Chi-square tests. Findings: At baseline, 57.9% of prescriptions contained at least one DRP, predominantly dosage regimen-related problems, with incorrect timing of administration being the most frequent (32.20%). In multivariable analysis, prescriptions issued by male prescribers had higher odds of DRPs (odds ratio 2.51, 95% confidence interval 1.51–4.18), whereas prescriptions for children aged 2–6 years and 6–12 years had lower odds than those for children aged ≤2 years. Following the intervention, DRP prevalence decreased significantly to 40.2% ( P < 0.001), with marked reductions in timing- and dosing-related DRPs. Conclusion: A structured, low-cost pharmacist-led intervention integrated into routine outpatient practice was associated with a clinically meaningful reduction in DRPs. Strengthening clinical pharmacy services is a feasible and scalable strategy to improve pediatric prescribing safety in resource-limited settings where systematic medication review and electronic decision support are constrained.