Drug-related problems identified during geriatric medication review in the community pharmacy

Abstract

Background In line with the changing role of community pharmacists, we describe here a standardised procedure for detecting DRPs in elderly patients for use in community pharmacies. Objectives The primary aim was to describe the number and type of DRPs identified by community pharmacists in elderly patients. Secondary aims were to determine the number and type of associated pharmacist interventions (PIs) that were transmitted to the prescribers, and to identify risk factors associated with the occurrence of a PI. Setting Community pharmacies. Methods In this prospective, multicentre study, pharmacists received patients aged 65 and over. During a 30-min interview with patients who agreed to participate, patient characteristics were recorded such as age, weight, height, frailty (using the Short Emergency Geriatric Assessment grid), estimated renal function and compliance with treatment assessed by the Girerd scale. Main outcome measure DRPs characteristics. Results A total of 892 patients agreed to participate in 55 pharmacies. Among them 334 DRPs were identified and were associated with 259 PIs. Eighty-nine PIs of 259 were sent to the prescribing physicians; 70 (78%) were implemented by the general practitioner. Factors associated with the occurrence of a DRP are compliance problems [odds ratio (OR) = 1.8, 95% confidence interval (CI) (1.26-2.58)], frailty [OR = 1.3, 95% CI (1.01-1.66)], number of prescribed drugs per day [OR = 1.46, 95% CI (1.02-2.07)] and GFR < 60 mL/min [OR = 1.49, 95% CI (1.01-2.2)]. Conclusion This is the first standardised pharmaceutical assessment dedicated to the elderly carried out by community pharmacists in France. If implemented, it could help to find drug-related problems, identify frail elderly patients and ultimately decrease their exposure to iatrogenic medication errors.

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

“…In previous studies, the average number of DRPs per person was lower than the result in our study. 15,16 There might be several explanations for why the number of DRPs in this study was higher than in other studies. First, our study was conducted in a tertiary hospital rather than a community pharmacy.…”

Drug-related Problems in Home-dwelling Older Adults: A Systematic Review

“…Among the included studies, eight were conducted in Europe, 14e20,24 two in Australia, 12,21 two in North America, 22,23 and one in Asia. 13 Regarding the study design, three studies were retrospective, 12,19,21 three studies were prospective, 13,16,20 four studies were randomized controlled trials, 15,17,22,23 and two studies were crosssectional. 14,18 The included studies identified DRPs during the MR process; according to the "PCNE statement on medication review 2013," 25 four studies performed a PCNE type 1/basic MR, 12,17,21,24 two studies performed a PCNE type 2b/intermediate MR, 14,20 and six studies performed a PCNE type 3/ advanced MR. 13,15,16,18,22 Three studies analyzed the impact of patients' participation in the improvement of the MR process.…”

Incidence, types and acceptability of pharmaceutical interventions about drug related problems in a general hospital: an open prospective cohort

“…The simplified 100% review of MO by clinical pharmacists, prior to drug dispensing, is one of the main strategies for DRP prevention in patients followed at various levels of healthcare, [36][37][38] especially in a hospital environment, where the risk of DRP is related to several factors such as polypharmacy, comorbidities, use of high-risk medication, renal/hepatic insufficiency, clinical condition, prolonged hospitalisation, among others. 23 39 This is a very common reality in most health services.…”