DRUG-RELATED PROBLEM AMOMG ELDERLY INPATIENTS AT SABHA MEDICAL CENTER
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Date
2019
Authors
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Journal ISSN
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Publisher
جامعة سبها
Abstract
Background: Elderly patients are prone to drug-related problems due to age-related
changes in physiology, comorbidities, and polypharmacy as well as the complexity of their
medication regimens.
Objective: The study aimed to examine the demographic and medical characteristics of
elderly inpatients and identifying patterns of drug prescribing and Drug-related problems.
Methodology: This study was a descriptive and retrospective cross-sectional study
designed to review patient records and identifying drug-related problems of elderly patients
who admitted to SMC during years 2019. Drug-related problems were identified and
classified according to Hepler and Strand classification (1990).
Results: From examined 1000 patients records approximately 20% (n=195) of these
patients had enough documented information and were selected for this study. Both
gender's male and female were approximately similar which accounted with (102,
52%), and (93, 47.6%) respectively. The majority of the patient was less than 85 years
which accounted for (151, 77%) and the period of staying in the hospital was at least
3 days which account with (73%) of the patients.
Out of 195 participants of the study, nearly two-thirds (65%) have at least
3comorbidites. Electrolyte imbalance was the highest prevalence rate which was
represented by (142, 72%). Hypertension and diabetes were reported by (116, 59%),
(73, 37%) respectively while the combined of this disease was less prevalent
(47,24%). Other comorbidities were reported as anemia (48.7%), infection (73, 37%),
and heart diseases (68,34%). However, the lowest rate was reported for CVA which
accounted for (32%) of patients. Almost all patients have polypharmacy (96%) and
most of these patients have been given antibiotics (92%). The majority of patients
have been prescribed anti gastric agents, vitamins, and anti-thrombotic agents which
accounted for (75%), (62%) and (55%) respectively. To less extent, antihypertensive
agents, analgesics, antihyperlipidemic were reported by (45%), 43%), and (38%)
correspondently.
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Almost all patients have at least one event of DRPs and more than three-quarters of
patients in our analysis had more than one event of DRP according to Hepler and
Strand classification. The highest rate was untreated indications which were reported
for (151, 77%) then followed by drug use without indication nearly a half of events
(93, 48%). To fewer extent rates were reported: “in improper drug selection”, “drug
interaction” and “adverse effects” which they were reported for (49, 25%),(44, 23%)
and (36, 18%) of the total events respectively. Minority events were represented
among overdosage (19,10%) and subtherapeutic dosage (15, 8%).
Conclusion: The study reveals that comorbidities, polypharmacy, and drug-related
problems are common. SMC should implement strategies to decrease the high
prevalence of DRPs among their elderly patients. Those problems could be reduced
by clinical pharmacist intervention whose plays a major role in providing healthcare
to the elderly. The study highlights the importance that clinical pharmacists should be
enabled to engage in hospital medical teams for the treatment of geriatric inpatients to
optimize pharmacotherapy since the older adults have multiple chronic diseases and
often use polypharmacy.