Potentially Inappropriate Medication Use Among Older Hospitalized Patients in a Brazilian General Hospital

Rationale, aims and objectives: Literature have showed inconclusive or contradictory results regarding medication review services effectiveness in optimizing process indicators. Thus, this study aimed to evaluate the process indicators of a medication review service between pharmacists and physicians. Method: This quasi-experimental study was conducted between March 2013 and February 2014 with patients who were receiving care in a medication review service in a teaching hospital in northeastern Brazil. The main process indicators were number of pharmaceutical consultations; identification and resolution of drug-related problems (DRP) and pharmaceutical interventions that were classified according to type and degree of acceptance. Descriptive statistics were used to report data. The statistical significance of the association between variables was evaluated using the Mantel-Haenszel chi-square test. The 95% confidence interval was considered, and differences were deemed statistically significant if P ≤ .05. Results: A total of 146 patients attended the medication review service. The number of consultations per patient ranged from one to five (2.1 ± 1.1). The service identified 366 DRP, most of which were indication (67.5%). Patients who had four to five pharmaceutical consultations were 1.14 times more likely to have their DRP identified (χ 2 = 33.83, P < .0001). Of the DRP identified, 183 (42.33%) were resolved. Patients who had between one and two pharmaceutical consultations were 1.22 times more likely not to have their DRP resolved compared with the group with more than three consultations (χ 2 = 3.44, P < .05). Of the 173 pharmaceutical interventions made to the medical students and physicians, the majority (98.7%) was accepted. Conclusion: The collaborative medication review service optimized the process indicators. Drug-related problems identification and resolution required more than three pharmaceutical consultations. Most of the pharmaceutical interventions were

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Evaluation of process indicators of a medication review service between pharmacists and physicians

Marques

Silva

Júnior

et al. 2019

Evaluation Clinical Practice

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Drug Related Problems among Older Inpatients at a Tertiary Care Setting

Pramotesiri,

Putthipokin,

Ruangritchankul

2024

JCM

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Background: Older persons are more likely to have multiple chronic diseases, leading to the simultaneous use of many medications. This situation results in increased drug-related problems (DRPs), which are the causes of adverse health outcomes. Therefore, we aimed to evaluate the prevalence of and associated risk factors for exposure to >1 criterion of DRPs among older adults admitted to a tertiary care hospital. Methods: We conducted a cross-sectional study involving 357 participants aged ≥60 years admitted to Ramathibodi Hospital from 1 February 2022 to 30 November 2022. The participants were evaluated for baseline characteristics, medications and DRPs and were classified into two groups, according to their exposure to DRPs: patients with exposure to ≤1 criteria and patients with exposure to >1 criterion of DRPs. Multivariate logistic regression analysis was performed to determine the independent risk factors for exposure to >1 criterion of DRPs. Results: Overall, 205 (57.4%) patients experienced >1 criterion of DRPs. Approximately 67.8%, 71.7% and 7.6% of the participants were exposed to at least one potentially inappropriate medication (PIM), drug–drug interaction (DDI) and adverse drug events (ADE), respectively. The most frequently prescribed PIMs were proton pump inhibitors (PPIs) (17.3%). Antineoplastics (48.1%) were the most frequently drug class related to ADEs. Overall, 37% of the ADEs in the current study were considered preventable ADEs. After adjustment for potential confounders, polypharmacy and the use of proton pump inhibitors, hypoglycemics, diuretics, psycholeptics, psychoanaleptics and cardiac therapy medications were correlated with a higher risk of exposure to > 1 criterion of PIMs, DDIs or ADEs. Conclusions: Therefore, comprehensive medication reviews and careful medication prescriptions are recommended in the geriatric population.

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Potentially Inappropriate Medication Use Among Older Hospitalized Patients in a Brazilian General Hospital

Cited by 2 publications

References 23 publications

Evaluation of process indicators of a medication review service between pharmacists and physicians

Evaluation of process indicators of a medication review service between pharmacists and physicians

Drug Related Problems among Older Inpatients at a Tertiary Care Setting

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