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 12 publications

(11 citation statements)

References 24 publications

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“…According to some studies, medication reconciliation programs can help to reduce medication-related problems. It is worth noting that medication conference activities and education on medication self-management can enhance the nursing team’s actions, favoring patient safety in CT ( 31 - 32 ) .…”

Section: Discussionmentioning

confidence: 99%

Hospital discharge planning in care transition of patients with chronic noncommunicable diseases

Barbosa,

Zacharias,

Schönholzer

et al. 2023

Rev. Bras. Enferm.

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Objective: to analyze care transition in hospital discharge planning for patients with chronic noncommunicable diseases. Method: a qualitative study, based on the Care Transitions Intervention theoretical model, with four pillars of intervention, to ensure a safe transition. Twelve professionals participated in a public hospital in the countryside of São Paulo. Data were collected through observation, document analysis and semi-structured interviews. Results: there was a commitment of a multidisciplinary team to comprehensive care and involvement of family members in patient care. The documents facilitated communication between professionals and/or levels of care. However, the lack of time to prepare for discharge can lead to fragmented care, impairing communication and jeopardizing a safe transition. Final considerations: they were shown to be important elements in discharge planning composition, aiming to ensure a safe care transition, team participation with nurses as main actors, early discharge planning and family involvement.

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Section: Discussionmentioning

confidence: 99%

Hospital discharge planning in care transition of patients with chronic noncommunicable diseases

Barbosa,

Zacharias,

Schönholzer

et al. 2023

Rev. Bras. Enferm.

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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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“…Transitions of care—like a discharge home after hospitalisation—heighten the risk of MRPs 1 6 10 13. An integrative review by Valente et al reported that the main MRPs among older adults during care transitions between hospital and home were related to the absence of medication reconciliation (40%), medication adherence (30%) and adverse drug events (30%) 14. Those MRPs were related to the greater number of medications prescribed during hospitalisation, modifications to the therapeutic regimen, incomplete, inaccurate or illegible prescriptions, and older adults’ lack of knowledge about their prescribed medications.…”

Section: Introductionmentioning

confidence: 99%

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 12 publications

References 24 publications

Hospital discharge planning in care transition of patients with chronic noncommunicable diseases

Hospital discharge planning in care transition of patients with chronic noncommunicable diseases

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

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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