<p>Evaluation of pharmacist interventions and commonly used medications in the geriatric ward of a teaching hospital in Turkey: a retrospective study</p>

Abstract

Aging increases the prevalence of diseases. The elderly population is consequently often exposed to complex medication regimens. Increased drug use is one of the main reasons for drug-related problems (DRPs). The primary objective of this study was to define and classify DRPs, pharmacist interventions, and frequently prescribed medications in relation to possible DRPs in patients admitted to the geriatric ward of a teaching hospital in Turkey. Patients and methods: Pharmacist medication review reports for 200 orders of 91 patients (mean age: 80.33±0.46) were analyzed retrospectively. Results: A total of 1,632 medications were assessed and 329 interventions were proposed for possible DRPs in 156 orders. A total of 87.5% of the patients used five or more drugs (mean: 8.17±0.23). The number of DRPs per order was higher when polypharmacy was present (1.04±0.15 vs 1.66±0.11, P,0.05). In 71.31% of the cases, adverse drug events were recognized as the problem. The principal cause of possible DRPs was determined as drug interactions (40.12%). Only 22 potentially inappropriate medications were prescribed. The most common interventions included monitoring drug therapy (31.0%), stopping the drug (20.06%), and changing dosage (13.98%). The acceptance rate of pharmacist interventions by treating geriatrician was 85.41%. The most frequently prescribed drugs were for the nervous system, alimentary tract and metabolism, and cardiovascular system (n=358, 314, and 304, respectively). The pharmaceutical forms of 23 drugs were deemed inappropriate by pharmacists. Conclusion: Clinical pharmacy services are still not properly implemented in Turkey. The study highlights ways in which clinical pharmacy services can be instrumental in a geriatric ward. The high acceptance rates of pharmacist recommendations concerning a wide variety of DRPs and different classes of drugs indicate that advanced collaboration among geriatricians and pharmacists is possible in interdisciplinary geriatric assessment teams in Turkey.

The pharmaceutical care bundle: development and evaluation of an instrument for inpatient monitoring

“…Adherence rates and the mean number of interventions per patient were consistent with the results of previous studies [14][15][16] . Pharmaceutical interventions were fully implemented for the items delirium, hospital discharge and validation of medication use.…”

Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities

“…With the continuous progress of healthcare reform, a series of regulations and guidelines have been released to emphasize the responsibility of pharmacists in promoting appropriate medication in both hospital and community pharmacy settings (30). Several studies have found that pharmacists played an important role in improving outcomes and decreasing drug-related readmissions and mortality in geriatric patients (12). Consequently, pharmacists and physicians should be trained in geriatric medication base on the criteria to enhance the quality of pharmaceutical care.…”

“…In recent years, accumulated studies have shown that PIMs were important causes of ADRs/adverse drug events (ADEs) in the elderly and were associated with a greater risk of hospitalization in that group (11). A retrospective study highlighted the role of PIMs-based clinical pharmaceutical care in geriatric wards and showed that pharmacists contributed to health care services by presenting a wide range of acceptable interventions to various drug-related problems, different categories, and drug forms based on PIMs and other guidelines (12).…”

Impact of clinical pharmacy recommendations and patient counselling program among patients with diabetes and cancer in outpatient oncology setting

“…Furthermore, a joining collaboration between the Society of Clinical Pharmacy and the Turkish Pharmacists’ Association Academy of Pharmacy organising several educational programs and sessions on clinical pharmacy and pharmaceutical care result in improved clinical pharmacy responsibilities particularly among community pharmacists. However, there is a considerable need to expand the role of pharmacist and the effective services of clinical pharmacy for patient care process in hospitals particularly outpatient oncology settings in Turkey (Ertuna et al., 2019; Sancar, Okuyan, Apikoglu‐Rabus, & Izzettin, 2013). To our knowledge, there is no study conducted on the impact of clinical pharmacy services and counselling program on patient‐related outcomes in patients with diabetes receiving chemotherapy at the outpatient oncology setting in Turkey.…”