Drug-Related Problems in the transitional care of the elderly from hospital to home

Valente, Silvia Helena; Barbosa, Sara Maria; Ferro, Denise; Fabriz, Luciana Aparecida; Schönholzer, Tatiele Estefâni; Pinto, Ione Carvalho

doi:10.1590/0034-7167-2018-0848

Cited by 9 publications

(3 citation statements)

References 24 publications

(56 reference statements)

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“…23 Many studies showed that DRPs can increase morbidity, length of hospitalization, mortality and medical expenditures, and cause a heavy burden on patients and society. [24][25][26] The majority of previous studies on DRPs for patients with ischemic stroke concerned patients in the acute phase of ischemic stroke treated in a hospital. As a member of the multidisciplinary care team (MDT), the pharmacist participated in the treatment process from admission to discharge, and there were 0.32-1.8 DRPs on average.…”

Section: Introductionmentioning

confidence: 99%

Drug-related problems among community-dwelling elderly with ischemic stroke in China

Tian¹,

Wu²,

Zhan³

et al. 2023

Adv Clin Exp Med

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Background. Ischemic stroke incidence is increasing amongst elderly patients in China; this is closely associated with drug-related problems (DRPs).Objectives. To evaluate the influencing factors of DRPs among elderly patients with a history of ischemic stroke in the Chinese community and the role clinical pharmacists play in providing solutions. Materials and methods.This study was conducted in 2 community health service centers in Putuo District, Shanghai, China, between December 2018 and June 2019. Demographics and clinical characteristics of the 130 selected patients were collected. Drug-related problems were classified using the Pharmaceutical Care Network Europe (PCNE)-DRP V8.03 classification system. The number, types, causes, interventions, and status of DRPs were then analyzed. Results.The average number of DRPs per patient was 1.3, corresponding to 256 causes. "Treatment effectiveness P1" was identified as the most common problem (75.0%). The main causes were "drug selection C1" (33.2%) and "patient-related C7" (30.9%). Antihypertensive drugs, statins, aspirin, and Chinese patent medicines were the top 4 drugs for DRPs. Age, unintentional medication discrepancy and medication compliance were independent predictors of DRPs. Pharmacists provided 339 interventions, mainly "at drug level I3" (38.9%) and "at patient level I2" (30.7%). Most of the interventions (85.5%) were accepted by the patients and 65.9% of the problems were solved.Conclusions. The number, types and etiology of DRPs in elderly patients with ischemic stroke in our community are diverse and treatment effectiveness is the main cause of their occurrence. Clinical pharmacists play an important role in providing interventions for major causes of DRPs.

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Section: Introductionmentioning

confidence: 99%

Drug-related problems among community-dwelling elderly with ischemic stroke in China

Tian¹,

Wu²,

Zhan³

et al. 2023

Adv Clin Exp Med

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“…Em uma revisão integrativa, realizada pelo GAAPS, foi identificado que a Discrepância de Medicamentos, a baixa Adesão aos Medicamentos e Eventos Adversos a Medicamentos (EAM) são PRM frequentes após a alta hospitalar. A reconciliação de medicamentos foi evidenciada como estratégia coerente e eficaz, nas transições de cuidado do idoso para casa (VALENTE et al, 2019).…”

Section: Transição Do Cuidadounclassified

“…A Reconciliação Medicamentosa pode ser definida como uma avaliação completa da terapêutica medicamentosa do paciente, sempre que ocorrer alteração no tratamento, para evitar erros de medicamentos, tais como omissões, duplicações, erros de dose ou interações medicamentosas, bem como para observar padrões de adesão ao tratamento medicamentoso (VALENTE et al, 2019).…”

Section: Reconciliação Medicamentosaunclassified

A construção de um protocolo de transição do cuidado de idosos do hospital para casa na perspectiva de quem cuida e de quem é cuidado

Valente¹

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AGRADECIMENTOS À Deus, todo poderoso, e aos meus queridos anjos guardiões pela oportunidade de evolução intelectual nessa reencarnação. Aos amores da minha vida, Ronaldo e Felipe, por compartilharem comigo essa experiência. Foram resilientes, abrindo mão, em muitos momentos, da minha presença junto a eles. À minha orientadora, Profª. Drª. Ione Carvalho Pinto, pela oportunidade de desenvolvimento e aprendizado, pela paciência e pelo coração enorme. Foi o seu apoio e motivação, em tempos de Pandemia, que me fizeram manter firme a execução desta pesquisa. Ao Grupo de Altos Estudos de Avaliação de Processos e Práticas da Atenção Primária à Saúde e Enfermagem (GAAPS), em especial a Fabiana Costa Machado Zacharias, pelo trabalho em equipe e pelo compartilhamento de novos conhecimentos.

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Development of a patient-centred medication management model for polymedicated home-dwelling older adults after hospital discharge: results of a mixed methods study

Pereira,

Meyer-Massetti,

del Río Carral

et al. 2023

BMJ Open

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ObjectiveThis study aimed to investigate medication management among polymedicated, home-dwelling older adults after discharge from a hospital centre in French-speaking Switzerland and then develop a model to optimise medication management and prevent adverse health outcomes associated with medication-related problems (MRPs).DesignExplanatory, sequential, mixed methods study based on detailed quantitative and qualitative findings reported previously.SettingHospital and community healthcare in the French-speaking part of Switzerland.ParticipantsThe quantitative strand retrospectively examined 3 years of hospital electronic patient records (n=53 690 hospitalisations of inpatients aged 65 years or older) to identify the different profiles of those at risk of 30-day hospital readmission and unplanned nursing home admission. The qualitative strand explored the perspectives of older adults (n=28), their informal caregivers (n=17) and healthcare professionals (n=13) on medication management after hospital discharge.ResultsQuantitative results from older adults’ profiles, affected by similar patient-related, medication-related and environment-related factors, were enhanced and supported by qualitative findings. The combined findings enabled us to design an interprofessional, collaborative medication management model to prevent MRPs among home-dwelling older adults after hospital discharge. The model comprised four interactive fields of action: listening to polymedicated home-dwelling older adults and their informal caregivers; involving older adults and their informal caregivers in shared, medication-related decision-making; empowering older adults and their informal caregivers for safe medication self-management; optimising collaborative medication management practices.ConclusionBy linking the retrospective and prospective findings from our explanatory sequential study involving multiple stakeholders’ perspectives, we created a deeper comprehension of the complexities and challenges of safe medication management among polymedicated, home-dwelling older adults after their discharge from hospital. We subsequently designed an innovative, collaborative, patient-centred model for optimising medication management and preventing MRPs in this population.

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Drug-Related Problems in the transitional care of the elderly from hospital to home

Cited by 9 publications

References 24 publications

Drug-related problems among community-dwelling elderly with ischemic stroke in China

Drug-related problems among community-dwelling elderly with ischemic stroke in China

A construção de um protocolo de transição do cuidado de idosos do hospital para casa na perspectiva de quem cuida e de quem é cuidado

Development of a patient-centred medication management model for polymedicated home-dwelling older adults after hospital discharge: results of a mixed methods study

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