Evaluation of drug related problems among hospitalised elderly patients at a secondary hospital in East Borneo
DOI:
https://doi.org/10.46542/pe.2024.243.240243Keywords:
DRP, Geriatric care, PCNE V9.00Abstract
Background: The elderly population often requires increased drug intake (polypharmacy) due to diminished organ function, particularly in the liver and kidneys, responsible for processing medications. Identifying drug-related problems (DRPs) in this demographic is crucial for mitigating morbidity, mortality, and overall drug therapy costs.
Objective: This study aimed to identify DRPs and their determinants in hospitalised geriatric patients.
Methods: An observational retrospective study was conducted in the Secondary Hospital in East Borneo from January 2019 - December 2021. Data were collected from medication charts, including patients aged 60-79, medical progress notes, and laboratories. DRPs were identified and classified using Pharmaceutical Care Network Europe’s (PCNE) classification V9.0.
Results: Of the 614 included patients, 79% were aged 60-69 years, 56.0% were male, and 73% were prescribed ≥ five medications. DRPs were identified in 75.2% of patients, primarily related to treatment effectiveness (27.19%) and treatment safety (53.42%). Causes included inappropriate monitoring (14.5%), improper drug combinations (51.79%), excessive drug dosage (16.61%), and inadequate drug dosage (13.51%).
Conclusion: The high frequency of DRPs, specifically concerning treatment effectiveness and safety, highlights the need for enhanced monitoring and prescribing procedures, contributing to preventing and treating future DRPs in the elderly population.
References
Budnitz, D. S., Lovegrove, M. C., Shehab, N., & Richards, C. L. (2012). Emergency hospitalisation for adverse drug events in older Americans. Survey of Anesthesiology, 56(2), 65–66. https://doi.org/10.1097/01.sa.0000412401.21757.36
Field, T. S., Gurwitz, J. H., Harrold, L. R., Rothschild, J. M., Debellis, K., Seger, A. C., Fish, L. S., Garber, L., Kelleher, M., & Bates, D. W. (2004). Strategies for detecting adverse drug events among older persons in the ambulatory setting. Journal of the American Medical Informatics Association, 11(6), 492–498. https://doi.org/10.1197/jamia.M1586
Helling, D. K., & Johnson, S. G. (2014). Defining and advancing ambulatory care pharmacy practice: It is time to lengthen our stride. American Journal of Health-System Pharmacy, 71(16), 1348–1356. https://doi.org/10.2146/ajhp140076
Lea, M. (2019). Towards safer drug therapy and improved clinical outcomes in elderly and multimorbid patients Oslo 2018 [University of Oslo]. http://hdl.handle.net/10852/69763
Niriayo, Y. L., Kumela, K., Kassa, T. D., & Angamo, M. T. (2018). Drug therapy problems and contributing factors in the management of heart failure patients in Jimma University Specialized Hospital, Southwest Ethiopia. PLoS ONE, 13(10), 1–14. https://doi.org/10.1371/journal.pone.0206120
OMS. (2009). Global priorities for patient safety research. Better knowledge for safer care. WHO Library Cataloguing-in-Publication Data, 12. http://apps.who.int/iris/bitstream/10665/44205/1/9789241598620_eng.pdf
Planas, L. G., Kimberlin, C. L., Segal, R., Brushwood, D. B., Hepler, C. D., & Schlenker, B. R. (2005). A pharmacist model of perceived responsibility for drug therapy outcomes. Social Science and Medicine, 60(10), 2393–2403. https://doi.org/10.1016/j.socscimed.2004.10.018
Skjøt-Arkil, H., Lundby, C., Kjeldsen, L. J., Skovgårds, D. M., Almarsdóttir, A. B., Kjølhede, T., Duedahl, T. H., Pottegård, A., & Graabæk, T. (2018). Multifaceted pharmacist-led interventions in the hospital setting: A systematic review. Basic and Clinical Pharmacology and Toxicology, 123(4), 363–379. https://doi.org/10.1111/bcpt.13030
Smith, C. P., & Christensen, D. B. (1996). Identification and clarification of drug therapy problems by Indian health service pharmacists. Annals of Pharmacotherapy, 30(2), 119–124. https://doi.org/10.1177/106002809603000201
Susilaningsih, F. S., Mediani, H. S., Kurniawan, T., Widiawati, M., Maryani, L., & Meharawati, I. (2017). Sosialisasi model praktik kolaborasi interprofesional pelayanan kesehatan di rumah sakit. Jurnal Aplikasi Ipteks Untuk Masyarakat, 06(1), 10–13.
