Recent Advances in Geriatrics: Drug-Related Problems in the Elderly

Hanlon, Joseph T.; Shimp, Leslie A.; Semla, Todd P.

doi:10.1345/aph.19140

Cited by 47 publications

(36 citation statements)

References 8 publications

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“…9,[11][12][13][14] There have also been studies quantifying the impact of postgraduate PharmD students on patient care, although most of these have been conducted in institutional and ambulatory care settings. [15][16][17] However, fewer studies have explored how community pharmacies can benefit as APPE placement sites.…”

Section: Discussionmentioning

confidence: 99%

An Enhanced Community Advanced Pharmacy Practice Experience Model to Improve Patient Care

Kassam¹,

Kwong²

2009

Am J Pharm Educ

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Objective. To quantify the benefits of an enhanced advanced pharmacy practice experience (APPE) community pharmacy model compared to the traditional program by comparing basic and comprehensive pharmaceutical care provided by students and assessing preceptors' perceptions of the APPE. Methods. A pilot study consisting of 1 enhanced APPE arm and 2 traditional APPE (control) arms was conducted. The enhanced APPE consisted of a preceptor education program, a 5-day onsite student orientation, and an 8-week experience completed at 1 rather than 2 community sites. Results. The level of interventions provided by students in the enhanced APPE arm significantly surpassed that of students in the control arms. In addition, preceptor questionnaires indicated overwhelming support for the enhanced model over the traditional APPE. Conclusions. The study's findings demonstrated that the enhanced APPE model enabled the participating pharmacies to provide increased level of patient care (as compared to the control sites) and improved preceptor satisfaction with the APPE.

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Section: Discussionmentioning

confidence: 99%

An Enhanced Community Advanced Pharmacy Practice Experience Model to Improve Patient Care

Kassam¹,

Kwong²

2009

Am J Pharm Educ

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“…While patients in the SC group also had a high prevalence of some risk characteristics, HHC patients appeared to differ in risk from SC patients and to be more similar to LTC patients. Interventions providing pharmaceutical care to high-risk patients in the community have been shown to identify and resolve DRPs 4,5,13,27 and to improve clinical and financial outcomes. 5,57,58 While it would be optimal but infeasible to provide institutional-level pharmaceutical care to all patients exposed to medication therapies, it may be possible to expand the level of pharmaceutical care received by LTC residents into the HHC population.…”

Section: Report Risk Of Adverse Drug Eventsmentioning

confidence: 99%

“…The recent passage of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 3 is intended to further enhance the access of seniors to medication therapies, and seniors are the subpopulation of Americans most likely to take multiple medications 2 and are at highest risk from medication use. 4,5 While the use of pharmaceuticals has positively affected important patient outcomes, resulting in generally accepted evidence-based guidelines for medication therapies, [6][7][8] drug use carries inherent dangers that can result in patient harm. 9 The Institute of Medicine in 1999 identified medical errors as a major public health problem and indicated that a large proportion of such errors are related to medications.…”

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confidence: 99%

Risk of adverse drug events by patient destination after hospital discharge

Triller

Clause

Hamilton³

2005

American Journal of Health-System Pharmacy

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“…Research, however, has identified problems in the effective use of medicines in this population 1 2. Adverse drug reactions are implicated in 5-17% of hospital admissions 1.…”

Section: Introductionmentioning

confidence: 99%

Appropriateness of use of medicines in elderly inpatients: qualitative study

Spinewine

Swine

Dhillon

et al. 2005

BMJ

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Objectives To explore the processes leading to inappropriate use of medicines for elderly patients admitted for acute care. Design Qualitative study with semistructured interviews with doctors, nurses, and pharmacists; focus groups with inpatients; and observation on the ward by clinical pharmacists for one month. Setting Five acute wards for care of the elderly in Belgium. Participants 5 doctors, 4 nurses, and 3 pharmacists from five acute wards for the interviews; all professionals and patients on two acute wards for the observation and 17 patients (from the same two wards) for the focus groups. Results Several factors contributed to inappropriate prescribing, counselling, and transfer of information on medicines to primary care. Firstly, review of treatment was driven by acute considerations, the transfer of information on medicines from primary to secondary care was limited, and prescribing was often not tailored to elderly patients. Secondly, some doctors had a passive attitude towards learning: they thought it would take too long to find the information they needed about medicines and lacked self directed learning. Finally, a paternalistic doctor-patient relationship and difficulties in sharing decisions about treatment between prescribers led to inappropriate use of medicines. Several factors, such as the input of geriatricians and good communication between members of the multidisciplinary geriatric team, led to better use of medicines. Conclusions In this setting, improvements targeted at the abilities of individuals, better doctor-patient and doctor-doctor relationships, and systems for transferring information between care settings will increase the appropriate use of medicines in elderly people.

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Recent Advances in Geriatrics: Drug-Related Problems in the Elderly

Abstract: Drug-related problems are considerable for elderly patients. Data from published studies should provide some guidance for today's practitioners as well as direction regarding future research.

Cited by 47 publications

References 8 publications

An Enhanced Community Advanced Pharmacy Practice Experience Model to Improve Patient Care

An Enhanced Community Advanced Pharmacy Practice Experience Model to Improve Patient Care

Risk of adverse drug events by patient destination after hospital discharge

Appropriateness of use of medicines in elderly inpatients: qualitative study

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