Clinical medication reviews in elderly patients with polypharmacy: a cross-sectional study on drug-related problems in the Netherlands

Autor: Sek Hung Chau, Petra J. M. Elders, Aaltje P. D. Jansen, Petra Hoogland, Jacqueline G. Hugtenburg, Peter M. van de Ven
Přispěvatelé: Clinical pharmacology and pharmacy, General practice, EMGO - Quality of care, Epidemiology and Data Science
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
Databases
Factual
Cross-sectional study
Psychological intervention
Pharmaceutical Science
Inappropriate Prescribing
Pharmacy
Toxicology
030226 pharmacology & pharmacy
Community pharmacists
0302 clinical medicine
Risk Factors
Prevalence
Medicine
Pharmacology (medical)
030212 general & internal medicine
Netherlands
Aged
80 and over
Age Factors
Older adults
Female
Independent Living
Patient Safety
Risk assessment
Research Article
medicine.medical_specialty
Drug-Related Side Effects and Adverse Reactions
Medication Therapy Management
Drug-related problems
Community Pharmacy Services
Patient care
Unnecessary Procedures
Drug Prescriptions
Risk Assessment
03 medical and health sciences
Patient safety
Pharmaceutical care
Medication Reconciliation
Medication therapy management
Humans
Aged
Pharmacology
Polypharmacy
business.industry
Clinical medication reviews
Cross-Sectional Studies
Family medicine
business
Zdroj: Chau, S H, Jansen, A P D, van de Ven, P M, Hoogland, P, Elders, P J M & Hugtenburg, J G 2016, ' Clinical medication reviews in elderly patients with polypharmacy: a cross-sectional study on drug-related problems in the Netherlands ', International Journal of Clinical Pharmacy, vol. 38, no. 1, pp. 46-53 . https://doi.org/10.1007/s11096-015-0199-8
International Journal of Clinical Pharmacy, 38(1), 46-53. Springer Netherlands
International Journal of Clinical Pharmacy
ISSN: 2210-7703
DOI: 10.1007/s11096-015-0199-8
Popis: Background Knowledge of drug-related problems (DRPs) identified in the medication of home-dwelling elderly patients with polypharmacy has been based predominantly on medication reviews conducted in research settings rather than in daily practice. Objective To evaluate the prevalence of DRPs identified by means of a clinical medication review (CMR) and the implementation rate of proposed interventions in a large group of older patients with polypharmacy in the daily practice of community pharmacies. Setting 318 Dutch community pharmacies. Method A cross-sectional study based on CMR-data of 3807 older patients (≥65 years) with polypharmacy (≥5 drugs) completed between January and August 2012. Data were extracted from community pharmacists’ databases and entailed: year of birth, gender, dispensing data, number and nature of identified DRPs, consultations performed, proposed and implemented interventions. Main outcome measure Prevalence of DRPs, drug classes involved in overtreatment and undertreatment, and proposed and implemented interventions. Results A median of two DRPs (interquartile range 1–4; mean 3.0) was identified per patient. The DRP-categories overtreatment (25.5 %) and undertreatment (15.9 %) were found most frequently. 46.2 % of the proposed interventions to solve DRPs were implemented as proposed, in 22.4 % of cases, the intervention differed from the proposal. In 31.3 % of cases no intervention was implemented. Conclusion By conducting a CMR community pharmacists identified a median of two DRPs in older patients with polypharmacy. Overtreatment and undertreatment accounted for 41.4 % of the DRPs identified. In dealing with DRPs, pharmacists proposed a variety of interventions of which the majority (69.9 %) was either implemented or led to alternative interventions. A set of explicit criteria should be applied during a CMR to solve and prevent DRPs.
Databáze: OpenAIRE
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