Drug-related problems in geriatric rehabilitation patients after discharge – A prevalence analysis and clinical case scenario-based pilot study

Freyer, Johanna; Hueter, Lucie; Kasprick, Lysann; Frese, Thomas; Sultzer, Ralf; Schiek, Susanne; Bertsche, Thilo

doi:10.1016/j.sapharm.2017.07.009

Cited by 9 publications

(6 citation statements)

References 31 publications

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“…Drug related problems are becoming a major public health concern. Geriatric patients are particularly highly vulnerable to DRPs caused by multiple factors such as polypharmacy and inappropriate prescribing [20]. Identification and prevention of DRPs occurrence in this population is crucial.…”

Section: Discussionmentioning

confidence: 99%

Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions

et al. 2020

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Background Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients often excluded from premarketing trials that can further increase the occurrence of DRPs. This study aimed to identify drug related problems and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization. Methods A prospective interventional study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems. Results A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR] = 4.350, 95% C.I: 1.212–9.260, p = 0.020) and number of comorbidities (AOR = 1.588, 95% C.I: 1.029–2.450, p = 0.037). Conclusions Drug related problems were substantially high among geriatric inpatients. Patients with polypharmacy and co-morbidities had a much higher chance of developing DRPs. Hence, special attention is needed to prevent the occurrence of DRPs in these patients. Moreover, clinical pharmacists’ intervention was found to reduce DRPs in geriatric inpatients. The prescriber acceptance rate of clinical pharmacists’ intervention was also substantially high.

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Section: Discussionmentioning

confidence: 99%

Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions

et al. 2020

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“…In the hospital setting, DRP may occur at all stages, from admission to discharge 20 – 25 . Certain conditions, drugs in specific therapeutic groups and variability of pharmacology knowledge across healthcare professionals could also be related to DRP 22 , 24 , 26 – 28 . However, there is controversy on the impact of these variables and others such as gender, age, social factors or readmissions on the risk of developing DRPs, especially in clinical practice 24 , 26 , 27 , 29 – 31 .…”

Section: Introductionmentioning

confidence: 99%

Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions

Garin

Solé

Lucas

et al. 2021

Sci Rep

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Drug-related problems (DRP) cause preventable negative health outcomes, especially during hospital admissions. The aim of our study was to examine the prevalence and characteristics of DRP in regular clinical pharmacy, as well as to determine those factors associated with a higher risk of DRP in the hospital setting. We analyzed data from a standardized registry database of regular pharmacy practice (2015- 2016). DRP were classified according to the Pharmaceutical Care Network Europe v6.2 classification. Cross-sectional data were obtained from 1602 adults admitted to medical wards. Crude and adjusted binary logistic regressions were performed to identify associations between potential risk factors and DRP. Overall DRP prevalence was high across medical specialties (45,1%), in a population characterized by advanced age, polypharmacy and multimorbidity. Problems leading to DRP were mainly classified into two domains (effectiveness and adverse reactions), being drug and dose selection the most frequent causes. Interventions were accepted and DRP were totally or partially solved in 74.1% and 4.81% of cases, respectively. In the adjusted model polypharmacy, allergies, BMI > 25 kg/m2 and clearance < 30 mL/min were associated with a higher risk of DRP. The participation of clinical pharmacists into multidisciplinary teams promotes the detection and solution of DRP. Polypharmacy, obesity, renal impairment and allergy are associated with a higher risk of DRP during admission.

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“…Various factors may influence the manifestation of DRPs, for example, body characteristics such as a female gender, the age over 65 years, and differences in the knowledge of pharmacology among healthcare professionals, resulting in an increased risk of polypragmasy [35][36][37]. A variety of researchers have indicated a high risk of DRPs of MPs that have a predominantly renal route of excretion (anticoagulants or diuretics) [38,39].…”

Section: Results and Discussion System For Analyzing Problems Associa...mentioning

confidence: 99%

Review of publications on drug-related problems investigations in osteoporosis patients

Egorova,

Beitullaev,

Matveev

et al. 2024

Farm. farmakol. (Pâtigorsk)

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A chronic form of osteoporosis (OP) substantiates a long-term pharmacotherapy of patients, which increases the risk of adverse drug reactions (ADRs) during the therapy. The enhancement of requirements to the quality of safety monitoring carried out in the context of pharmacovigilance and the newly identified safety problems require an improvement of the system of quality control of medicinal products (MPs).The aim of the work was to review the application of a new promising method for monitoring the drug safety – the system of Drug-Related Problems (DRP) in the osteoporosis pharmacotherapy.Materials and methods. The following databases and search engines were used to retrieve scientific papers by Russian and foreign authors: PubMed, elibrary.ru, Google Scholar, CyberLeninka, Russian National Library. The information sources were searched using the following keywords and word combinations: “drug-related problems”, “drug safety”, “osteoporosis” (in Russian and English, respectively), as well as the corresponding MeSH terms.Results. The application of DRP system in the health care of different countries was reviewed, and the risk factors of the problems associated with the use of MPs, the appropriate interventions in case of the detection of high DRP values were investigated. The study of the problems associated with the use of MPs for the treatment of OP during the complex pharmacotherapy made it possible to determine the feasibility of using this method to improve the safety and effectiveness of this kind of treatment in patients.Conclusion. The analysis of emerging DRPs makes it possible to increase patients’ adherence to the treatment and stop the ADRs. This improves the quality of life of patients and increases the effectiveness of pharmacotherapy. The introduction of such a method of the drug safety research into the system of pharmacovigilance of the Russian Federation is an important step in the development of personalized medicine. A further study of problems associated with the use of drugs in OP patients will also help to reduce the risks arising during the combination pharmacotherapy.

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Drug-related problems in geriatric rehabilitation patients after discharge – A prevalence analysis and clinical case scenario-based pilot study

Cited by 9 publications

References 31 publications

Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions

Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions

Drug related problems in clinical practice: a cross-sectional study on their prevalence, risk factors and associated pharmaceutical interventions

Review of publications on drug-related problems investigations in osteoporosis patients

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