Drug-related problems (DRPs) identified from geriatric medication safety review clinics

• DOI: 10.1016/j.archger.2011.02.005
• Publication Date: 2011-02-25T09:38:24Z
• Authors: Ding-Cheng Chan; Jen-Hau Chen; Hsu-Ko Kuo; Chiung-Jung We; I-Shu Lu; Lee-Shu Chiu; Shwu-Chong Wu
• Keywords: Aged, 80 and over; Male; Medical Audit; Drug-Related Side Effects and Adverse Reactions; Taiwan; 16. Peace & justice; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Polypharmacy; Humans; Drug Interactions; Female; Aged

Drug-related problems (DRPs) were identified from baseline data of 193 Medication Safety Review Clinic (MSRC) patients. MSRCs enroll older adults (≥ 65 years) with either (1) prescriptions of ≥ 8 chronic medications (drugs prescribed for ≥ 28 days) or (2) a visit to ≥ 3 different physicians at the two participating hospitals in Taipei, Taiwan from August to October 2007. The Pharmaceutical Care Network Europe (PCNE) Classification Version 5.01 was used to report DRPs. Mean age was 76.2 ± 6.2 years and 53% of participants were male. Participants had, on average, 9.0 ± 2.6 chronic conditions and took 8.9 ± 3.1 chronic medications and 1.7 ± 1.8 dietary supplements. Eighty-seven percent had at least one DRP. Being older, having orthostatic hypotension and taking more chronic medications were associated with higher likelihood of having at least one DRP. For the 1713 medications and 331 diet supplements reviewed, 427 DRPs were found, 490 causes (1.1 ± 0.4 per problem) identified and 1067 interventions proposed (2.5 ± 0.6 per problem). The most common DRP category was "drug not taken/administered" (35%), and the most common offending drug category was cardiovascular agents (33%). Prevalence of DRPs was high among geriatric outpatients prescribed multiple medications. Careful medication review is needed in routine clinical practice to improve prescription quality.