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General and Risk Management, Patient Safety (including: medication errors, quality control)
A clinical pharmacist-based home medication review of geriatric patients
  1. P. Kumar
  1. 1Manipal College of Pharmaceutical Sciences, Pharmacy Practice, Manipal, India

Abstract

Background The world's population is rapidly ageing and the older are projected to increase from 600 million in 2000 to 1.2 billion in 2025.1 Medicines-related problems (MRP) are more common in geriatric patients and prescribing drug treatment for older patients is becoming more complex.2 Home medicines review by pharmacists helps patients manage the medicines and reduces the risk of MRP.

Purpose To assess the knowledge of the medicines, use of prescription drugs, polypharmacy, use of non-prescribed ayurvedic medicines and MRP among geriatric patients.

Materials and methods A prospective study was done by visiting houses in and around HUDCO colony, Manipal, India. A pharmacist interviewed the patients and their carers during a visit and reviewed all medicines used by patients. Data was documented and reviewed for the presence of MRP and the medicines usage pattern. A validated questionnaire was used to assess patient perception of the use of both systems of medicines. The study patients' knowledge of the medicines was assessed using a validated Medication Knowledge Assessment Questionnaire (MKAQ).

Results 219 geriatric patients (≥60 years) were included in the study of which 21% had polypharmacy. A total of 50.2% (110) had medicines-related problems. 64.5% (71) were taking non-prescribed ayurvedic medicines along with allopathic drugs, which was the most common medicines-related problem. Adverse drug reactions 40.9% (45) followed by failure to take the drugs 19.1% (21) were the other problems. Physicians were notified of the existence of potential medicines-related problems. Patients' knowledge of medicines was poor as assessed by recall of name, indications, strength and side effects of medicines. The patients' educational levels and age were found to be negatively associated with knowledge of their medicines.

Conclusions The study confirmed the existence of MRP along with more use and belief in ayurvedic medicines and poor knowledge of medicines among geriatric patients. Pharmacist services help to reduce medicines-related problems and improve care in geriatric patients.

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