Premium
Evaluation of drug‐related problems in older polypharmacy primary care patients
Author(s) -
Kovačević Sandra Vezmar,
Miljković Branislava,
Ćulafić Milica,
Kovačević Milena,
Golubović Bojana,
Jovanović Marija,
Vučićević Katarina,
Gier Johan J.
Publication year - 2017
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12737
Subject(s) - medicine , polypharmacy , psychological intervention , asthma , drug , aspirin , diabetes mellitus , medical prescription , deprescribing , intensive care medicine , pharmacotherapy , statin , proton pump inhibitor , pharmacology , psychiatry , endocrinology
Aims and Objectives Targeting older patients with predictive factors for drug‐related problems (DRPs) could make clinical medication reviews more cost‐effective. The aim of this study was to identify the number, type, and potential predictive factors for DRPs in older polypharmacy patients. Methods Community pharmacists performed clinical medication reviews and documented DRPs, types of interventions, and their implementation in older patients. Results Three hundred eighty‐eight medication reviews were analyzed, 964 DRPs (average 2.5 ± 1.9), and 1022 interventions (average 2.6 ± 2.0) were identified. The overall implementation rate of interventions was 70.1%, the highest was observed in interventions aiming to resolve the lack of therapy monitoring (86.8%). Patients with ≥12 medications had an increased risk of ≥5 DRPs ( P < .001). Asthma was associated with lack of adherence ( P = .002), lack of aspirin, statins, and proton pump inhibitors use with additional therapy needed ( P = .002‐.004). Predictive factors for drug interactions were antihypertensive medications and/or medications with narrow therapeutic index ( P < .05). Lack of efficacy was associated with diabetes ( P = .006). Nonsteroidal anti‐inflammatory drugs were risk factors for inappropriate drug selection ( P = .002). Lack of monitoring was associated with hypertension ( P = .013), whereas benzodiazepines ( P < .001) and aspirin ( P = .021) were overused. Conclusion Patients with asthma, hypertension, and diabetes and lack of statin, antithrombotic agent, and/or proton pump inhibitor use were associated with higher risks for DRPs.