Background and importance Medication-related problems (MRPs) are events or situations involving drug therapy that potentially interfere with the desired outcome for a patient. Elderly patients are especially vulnerable to these problems because of their comorbidity and polypharmacy.
Aim and objectives To estimate the prevalence of MRPs in a nursing home, identify the most frequently involved therapeutic groups and evaluate the degree of pharmaceutical interventions (PI) acceptance by the physician.
Material and methods A cross-sectional observational study was conducted (April 2021) in patients aged over 65 years in a nursing home. Electronic prescription program and clinical history were used to collect the following data: sex, age, drugs prescribed and therapeutic group, frailty index (FI), number and type of MRPs, PIs and degree of acceptance. FI was determined according to a frailty scale based on comprehensive geriatric assessment in nursing homes. Patients’ PIs were performed according to their FI, geriatric assessment scales and explicit criteria for inappropriate medication in geriatrics (Beers and STOPP-START) and were assessed by the physician.
Results Thirty-one patients (58.1% women) with mean age of 79 (62–96) years were evaluated. Seventeen patients (54.8%) were over 80 years old. Mean number of drugs prescribed was 8.1 (SD 3.2) and mean FI was 0.4 (SD 0.2) (moderate frailty). One-hundred and twenty-three MRPs were recorded, with a mean of 4 (SD 1.2) MRPs/patient. Most frequent MRPs were: probability of adverse effects (30%), low therapeutic utility (21%), inadequate duration (18%), inadequate dose (13%), untreated indication (10%), therapeutic duplicity (4%) and pathology–drug interaction (4%). Main therapeutic groups involved in MRPs were: antidepressants (19%), antipsychotics (12%), anti-inflammatories (5%), vitamin D derivatives (5%) and diuretics (5%).One-hundred and fourteen PIs were performed, with a mean of 3.7 PI/patient (SD 1.2). Most frequent PIs were: treatment discontinuation (48%), drug substitution (24%), dose adjustment (18%), treatment initiation (7%) and recommended administration (3%). Ninety PIs (79%) were accepted and 24 (21%) were not accepted.
Conclusion and relevance Our study showed a high prevalence of MRPs. Main therapeutic groups involved were psychotropic drugs (antidepressants and antipsychotics). High acceptance of PIs supports integration of pharmacist into multidisciplinary team of nursing homes, as it improves the safety and quality of patient care.
References and/or acknowledgements 1. Peris-Marti JF, et al. Approach to the development of a frailty index based on comprehensive geriatric assessment in nursing home. Farm Hosp 2018;42(4):159–162. doi: 10.7399/fh.10953.
Conflict of interest No conflict of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.