Characterization of drug‐related problems and associated factors in ambulatory patients in China

Wang, Xin; Yang, Jing; Yu, Xiaoming; Wang, Zihui; Wang, Huaguang

doi:10.1111/jcpt.13161

Cited by 7 publications

(7 citation statements)

References 26 publications

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“…Participants in the two latter studies had a higher number of medications and comorbidities than participants in the present study. Previous studies have indicated these factors increased the number of DRPs [6][7][8]30]. In this study, polypharmacy and multiple comorbidities were related to DRPs, consistent with previous research.…”

Section: Discussionsupporting

confidence: 91%

Prevalence and Associated Factors of Drug-Related Problems Among Older People: A Cross-Sectional Study at King Chulalongkorn Memorial Hospital in Bangkok

Paisansirikul

Ketprayoon

Ittiwattanakul

et al. 2020

Drugs - Real World Outcomes

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Background and Objective The use of multiple medications and altered pharmacokinetics/pharmacodynamics may lead to drug-related problems in members of the older population. The aim of this study is to evaluate the prevalence of, and factors related to, drug-related problems in older urban-living Thai people. Methods We conducted a cross-sectional study involving 466 participants (aged ≥ 65 years) whose first-time health screening at the Geriatric Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok was between May and October 2019. Participants were interviewed and assessed for drug-related problems by clinical pharmacists. Results In total, 54.5% (254) of the participants were aged 65–69 years and 77.0% (359) of the participants were women. Of the participants, 56.7% had three or more health conditions such as hyperlipidemia (62%), hypertension (46%), and cataract (18%). Fifty-five percent of the participants took five or more health products (polypharmacy) and 16% took ten or more products on a regular basis. Of the 2633 products used, 68% were prescription drugs and 32% were over-the-counter products. The prevalence of drug-related problems according to the criteria suggested by Cipolle–Strand–Morley (2012) was 63.3% (587 drug-related problems). Most of the problems came from: (a) non-adherence (28.6%); (b) needs for additional drug therapy (26.4%); and (c) adverse drug reactions (17.4%). Factors associated with drug-related problems were polypharmacy (odds ratio 2.50, 95% confidence interval 1.60–3.89) and multiple comorbidities [three or more conditions] (odds ratio 2.20, 95% confidence interval 1.41–3.43). Conclusions The prevalence of drug-related problems in urban-living older people at King Chulalongkorn Memorial Hospital in Bangkok was high. Polypharmacy and multiple comorbidities were significantly related to drug-related problems. To decrease the number of drug-related problems, pharmacists should collaborate with healthcare teams and suggest how to correctly reduce the number of health products being consumed by older people. Electronic supplementary material The online version of this article (10.1007/s40801-020-00219-2) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Prevalence and Associated Factors of Drug-Related Problems Among Older People: A Cross-Sectional Study at King Chulalongkorn Memorial Hospital in Bangkok

Paisansirikul

Ketprayoon

Ittiwattanakul

et al. 2020

Drugs - Real World Outcomes

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“…The prevention, identification and solution of DRPs constitutes the core of pharmaceutical care in which clinical pharmacists, together with the multi-disciplinary team (MDT), make an effort to improve therapeutic outcomes and the quality of life in patients [ 7 – 9 ]. Clinical pharmacists are involved in the entire treatment process from the beginning of patient hospitalization including medication reconciliation, participating in clinical ward rounds, providing medication consultation and so on.…”

Section: Introductionmentioning

confidence: 99%

Identification and solution of drug-related problems in the neurology unit of a tertiary hospital in China

Liu

Han

et al. 2021

BMC Pharmacol Toxicol

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Background The prevalence and characteristics of drug-related problems (DRPs) and factors associated with the occurrence of DRPs in the neurology unit in China remain unknown. This study aimed to determine the prevalence, characteristics and severity ratings of DRPs and identify factors associated with the occurrence of DRPs in the neurology unit of a tertiary care and academic teaching hospital in China. Methods A retrospective study of DRPs and pharmacists’ interventions for neurology patients was performed during a non-consecutive 24-month study period. Patient demographics and clinical characteristics, and pharmacist’s intervention records were collected. The characteristics and severity ratings of DRPs were categorized using the Pharmaceutical Care Network Europe (PCNE) DRP classification tool V9.00 and the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification respectively. Results A total of 242 DRPs were detected for 974 admitted patients, an average of 0.25 DRPs per patient. Treatment safety was the major type of DRPs (106;43.8%) followed by treatment effectiveness (78;32.2%). The primary causes of DRPs were drug selection (124;44.1%) and dose selection (92;32.7%). Clinical pharmacists provided 525 interventions, and most interventions occurred at the prescriber level (241;45.9%). A total of 91.4% of these interventions were accepted, contributing to solving 93.0% of the identified problems. The majority of DRPs (210;86.8%) were rated at severity categories B to D (causing no patient harm). Multiple logistic regression showed that creatinine clearance, number of medications used, nasogastric feeding, diabetes, and infectious diseases were associated with more frequent DRPs (p < 0.05). Conclusions DRPs are relatively common in the neurology unit in China, with primary causes of drug and dose selection, and clinical pharmacists can effectively reduce and prevent DRPs to optimize medication therapy.

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“…When the death rates were evaluated in terms of gender, the rate was higher in men than in women. 18 More specifically, in studies related to DRPs, problems in ambulatory patients, 19 neurological problems, 20 respiratory problems, and cardiac problems have been reported. 21,22 A drug-related problem (DRP) is defined as an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes.…”

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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Characterization of drug‐related problems and associated factors in ambulatory patients in China

Cited by 7 publications

References 26 publications

Prevalence and Associated Factors of Drug-Related Problems Among Older People: A Cross-Sectional Study at King Chulalongkorn Memorial Hospital in Bangkok

Prevalence and Associated Factors of Drug-Related Problems Among Older People: A Cross-Sectional Study at King Chulalongkorn Memorial Hospital in Bangkok

Identification and solution of drug-related problems in the neurology unit of a tertiary hospital in China

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

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