Characteristics of drug-related problems and pharmacists’ interventions in a geriatric unit in China

Ma, Zhuo; Sun, Shusen; Zhang, Caixia; Yuan, Xianrui; Chen, Qing; Wu, Junchen; Wang, Xiaojuan

doi:10.1007/s11096-020-01128-8

Cited by 15 publications

(16 citation statements)

References 8 publications

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“…Since 2018, the PCNE DRP classification has been introduced into clinical pharmacy services at Chinese hospitals, and it has gained popularity as a DRP documentation tool. Studies have demonstrated that pharmacist-provided medication review can detect and resolve DRPs in diverse patient populations at Chinese hospitals, such as surgical patients [ 3 ], elderly patients [ 4 ], stroke patients [ 5 ], and patients with respiratory diseases [ 6 , 7 ]. However, there has been no analysis of assessing DRPs in hospitalized elderly surgical patients from China.…”

Section: Introductionmentioning

confidence: 99%

Drug-Related Problems among Hospitalized Surgical Elderly Patients in China

Meng

Xia

et al. 2021

BioMed Research International

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There is a lack of data on drug-related problems (DRPs) among elderly patients from surgical departments. The current study is aimed at identifying and categorizing types of DRPs and assessing the severities of the DRPs. Medication orders for hospitalized patients aged ≥65 years from six surgery departments were reviewed to determine DRPs over 6 months in a tertiary teaching hospital of Chongqing, China. DRPs were classified based on the Pharmaceutical Care Network Europe classification V8.02. The severity ratings of the DRPs were assessed using the National Coordinating Council for Medication Error Reporting and Prevention classification. A total of 53,231 medication orders from 1,707 elderly patients were reviewed, and 1,061 DRPs were identified. Treatment safety (44.9%) was the most common DRP type. Drug selection (43.1%) and dose selection (43.1%) were the major causes of DRPs. A total of 75.1% of the DRPs were classified into severity categories B to D (causing no or potential harm), and 24.9% were classified as categories E to H (causing actual harm). DRPs are common in hospitalized elderly surgical patients. Pharmacists should provide medication order reviews in this vulnerable patient population.

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Section: Introductionmentioning

confidence: 99%

Drug-Related Problems among Hospitalized Surgical Elderly Patients in China

Meng

Xia

et al. 2021

BioMed Research International

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“…Patients who stayed in the hospital for seven or more days were 2.3 times more likely to have DRPs; it is supported by a meta-analysis conducted in Ethiopia [ 45 ], a study in China [ 29 ], and a multicenter prospective study in southwestern Ethiopia [ 42 ]. The reason might be the likelihood of infection in patients who stayed in the hospital for a long time necessitates more management, which raises the expense of patient healthcare.…”

Section: Discussionmentioning

confidence: 91%

Clinical Pharmacist Intervention on Drug-Related Problems among Elderly Patients Admitted to Medical Wards of Northwest Ethiopia Comprehensive Specialized Hospitals: A Multicenter Prospective, Observational Study

Dagnew

Mekonnen

Zeleke

et al. 2022

BioMed Research International

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Background: Drug therapy in the elderly needs an emphasis on age-related changes in drug pharmacokinetics and pharmacodynamics profile. Hospitalized elderly patients are at risk of more than one disease and polypharmacy associated with these; they are at risk of drug-related problems. This study aimed to assess the role of clinical pharmacy on identifying and resolution of drug-related problems among elderly patients admitted to medical ward of Northwest Ethiopia comprehensive specialized hospitals. Methods: A multicenter prospective observational study was conducted. A systematic sampling technique was used. The identified drug-related problem was recorded and classified using Cipolle, and adverse drug reaction was assessed using Naranjo algorithm of adverse drug reaction probability scale, and Medscape was used for drug-drug interaction. Data were analyzed by using STATA software version 14.1. Logistic regression was used, and results were reported as odds ratios (ORs) with 95% Confidence intervals with P value < 0.05 statistically significant. Result: A total of 389 study participants were included in the study. About 266 (68.4%) of the participants had at least a single drug-related problem. About 503 drug-related problems were identified with a mean of 1.32 (CI: 1.27-1.36) drug-related problem per patient. The three-leading categories of drug-related problems were dose too high 108 (21.5%), nonadherence 105 (20.9%), and adverse drug reaction 96 (19.1%). Alcohol use ( AOR = 2.2 , 95CI%: 1.23-3.94), source of the drug ( AOR = 2.85 , 95CI%: 1.63-4.98), length of hospitalization ( AOR = 2.32 , 95CI%: 1.37-3.95), number of comorbidities ( AOR = 1.48 , 95CI%: 1.09-1.99), and polypharmacy ( AOR = 3.06 , 95CI%: 1.72-5.46) were important risk factors for drug-related problems. From the intervention provided, 84.7% were accepted by prescribers. Among the total drug-related problems 67.4% of the problem was totally solved. Conclusion: This study revealed that DRPs were high among elderly patients admitted to medical ward of Northwest Ethiopia. Comorbidity, length of hospitalization, ploy-pharmacy, payer, and alcohol drinker were more likely to developed drug-related problems. Treatment optimizations were also done by clinical pharmacists and interventions were well accepted by prescribers.

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“…A taxa de aceitação das IFs no presente estudo foi de 85,9%, sendo que em outros estudos as taxas de aceitação também foram altas. Na China, por exemplo, alguns estudos apresentaram taxas acima de 90% 15,27,28 . Essas altas taxas refletem uma boa relação de confiança entre farmacêuticos e a equipe assistencial de médicos e enfermeiros, que atuam juntos com o intuito de resolver os PRMs e promover o uso racional e a segurança do paciente.…”

Section: Discussionunclassified

“…O estudo apresentou uma média de 1,5 PRM por paciente. Estudos semelhantes realizados em outros países trazem médias próximas como, por exemplo na Turquia onde foi identificada uma média de 1,6 PRM por paciente, na China 0,6 e na Suíça 2,6 14,15,16 .…”

Section: Os Medicamentos Envolvidos Nos Prms Foram Classificados De A...unclassified

“…Além disso, a média de idade da população estudada, tanto para homens quanto para mulheres foi superior a 60 anos, caracterizando uma população prevalentemente idosa. Estudos em população com problemas cardiovasculates demonstram que idosos acima de 60 anos tendem a apresentar mais PRMs pelo fato de possuírem mais comorbidades e condições crônicas, sendo, consequentemente, polimedicados 15 . Outra questão importante levantada por estudos prévios é a de que a combinação de comorbidade e polifarmácia pode aumentar as chances de desenvolver evento adverso relacionado a medicamento 14 .…”

Section: Os Medicamentos Envolvidos Nos Prms Foram Classificados De A...unclassified

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Identification of drugs-related problems and pharmacists’ interventions in a hospital in Southern Brazil

SPEZIA¹,

Cimarosti²

2022

Rev Bras Farm Hosp Serv Saude

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Objetivos: identificar problemas relacionados a medicamentos (PRMs) e realizar intervenções farmacêuticas (IFs) em prescrições médicas de um hospital e estimar seu impacto econômico para a instituição de saúde. Métodos: Trata-se de um estudo quantitativo transversal de natureza descritiva realizado de agosto de 2020 até setembro de 2021 em um hospital referência em atendimento cardiovascular. Foram analisadas pelas farmacêuticas do serviço as prescrições atendidas pelo serviço de farmácia da instituição. Os PRMs identificados foram classificados utilizando a ferramenta Pharmaceutical Care Network Europe (PCNE) versão 9.1, o impacto econômico foi mensurado pela ferramenta Clinical, Economics, Organization Impact (CLEO), os medicamentos envolvidos foram classificados conforme o Anatomical Therapeutic Chemical (ATC) os dados foram analisados por meio de tabela de Excel 2007. Resultados: Ao todo 857 PRMs foram identificados nas prescrições de 560 pacientes, com uma média de 1,5 PRM por paciente. O principal PRM encontrado foi no domínio de segurança, sendo o de possível reação adversa ao medicamento (39,1%), enquanto que a causa mais prevalente foram instruções de posologia incorretas, pouco claras ou ausentes (22,8%). A IF mais realizada foi a suspensão do medicamento (25,8%) e de alteração de instrução de administração (25,7%), sendo que 85,9% das IFs foram aceitas e implementadas gerando desfecho de problema totalmente resolvido e 41,8% geraram diminuição de gasto para a instituição. Conclusão: Foi possível identificar e realizar uma quantidade considerável de PRMs e IFs. Essas IF relizadas tiveram o objetivo de reduzir possíveis danos relacionados aos medicamentos, além de promover, na grande maioria das vezes, uma redução de custos para a instituição. A presença do farmacêutico atuando junto ao restante da equipe multidisciplinar de saúde mostrou-se essencial, tanto na promoção de segurança na farmacoterapia e redução de danos aos pacientes quanto na farmacoeconomia hospitalar.

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Characteristics of drug-related problems and pharmacists’ interventions in a geriatric unit in China

Cited by 15 publications

References 8 publications

Drug-Related Problems among Hospitalized Surgical Elderly Patients in China

Drug-Related Problems among Hospitalized Surgical Elderly Patients in China

Clinical Pharmacist Intervention on Drug-Related Problems among Elderly Patients Admitted to Medical Wards of Northwest Ethiopia Comprehensive Specialized Hospitals: A Multicenter Prospective, Observational Study

Identification of drugs-related problems and pharmacists’ interventions in a hospital in Southern Brazil

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