Drug Safety Center, University Hospital of Leipzig and Leipzig University and Dept. of Clinical Pharmacy, Leipzig University, Brüderstr. 32, 04103 Leipzig, Germany.
Geriatric Network (GeriNet) Leipzig, Pestalozzistr. 9, 04442 Zwenkau, Germany.
Res Social Adm Pharm. 2018 Jul;14(7):628-637. doi: 10.1016/j.sapharm.2017.07.009. Epub 2017 Jul 25.
Geriatric patients bear a high risk for having drug-related problems (DRPs). Transitions of care are especially susceptible to these DRPs.
To highlight the prevalence of DRPs in geriatric patients' post-discharge medication lists and to assess physicians' ability to identify DRPs by using clinical case scenarios.
A sequential prospective mixed-method study was performed. In a DRP prevalence analysis, an expert panel of clinical pharmacists analyzed DRPs in post-discharge medication lists of long-term hospitalized patients from a German inpatient geriatric rehabilitation center. Based on these results, the expert panel created two clinical case scenarios with applicable medication history. The cases were reflective of the most commonly identified DRPs. They were provided to hospital physicians and general practitioners (GPs) for assessment. Physicians were asked whether they approve the prescriptions in the clinical case scenarios. If a physician had not identified a prescription containing a defined DRP, the clinical pharmacist then provided drug information about it. With this, physicians' ability to identify DRPs and their response to a theoretical intervention was assessed.
DRP prevalence analysis: A total of 639 prescriptions were analyzed from 63 enrolled patients of whom 52 (83%) were affected by at least one DRP. Twenty-eight hospital physicians and 26 GPs have been assessed. They identified 172 (46%) from 378 possible DRPs (seven DRPs multiplied by 54 physicians). For unidentified DRPs, physicians received tailored drug information and the number of identified DRPs rose to 298 (79%).
A clear majority of patients were affected by DRPs. However, the results from the following pilot study confirm that many DRPs at care transitions can be reduced by providing applicable medication history and drug information. This intervention can be done by clinical pharmacists as part of the multidisciplinary care team in routine care.
Geriatric patients bear a high risk for having drug-related problems (DRPs). Strategies to protect them are needed, especially during transitions of care due to information and knowledge gaps. Therefore a sequential prospective mixed method study was performed. Initial post-discharge medication lists of geriatric patients were analyzed for DRPs with 83% of patients being affected. Afterwards, physicians' ability to identify DRPs was assessed based on clinical case scenarios. These clinical case scenarios included an applicable medication history and tailored drug information was provided. Under these conditions, physicians identified many of the defined DRPs.
老年患者存在较高的药物相关问题（DRP）风险。在医疗护理交接期间，这种风险尤其突出。
强调在老年患者出院后的药物清单中 DRP 的普遍性，并通过临床案例场景评估医生识别 DRP 的能力。
采用序贯前瞻性混合方法进行研究。在 DRP 患病率分析中，临床药剂师专家组分析了一家德国住院老年康复中心长期住院患者出院后药物清单中的 DRP。基于这些结果，专家组创建了两个具有适用药物史的临床案例场景。这些案例反映了最常见的 DRP。将这些案例提供给医院医生和全科医生（GP）进行评估。要求医生判断临床案例场景中的处方是否合理。如果医生没有识别出包含特定 DRP 的处方，则临床药剂师将提供有关该药物的信息。通过这种方式，评估了医生识别 DRP 的能力及其对理论干预的反应。
DRP 患病率分析：对纳入的 63 名患者的 639 份处方进行了分析，其中 52 名（83%）患者至少存在一种 DRP。共评估了 28 名医院医生和 26 名全科医生。他们从 378 个可能的 DRP（7 个 DRP 乘以 54 名医生）中识别出了 172 个（46%）。对于未识别出的 DRP，医生收到了有针对性的药物信息，随后识别出的 DRP 增加到 298 个（79%）。
大多数患者都受到 DRP 的影响。然而，以下试点研究的结果证实，通过提供适用的药物史和药物信息，可以减少许多医疗护理交接期间的 DRP。这种干预可以由临床药剂师作为多学科护理团队的一部分，在常规护理中进行。
老年患者存在较高的药物相关问题（DRP）风险。由于信息和知识差距，需要采取策略来保护他们，尤其是在医疗护理交接期间。因此，进行了一项序贯前瞻性混合方法研究。首先分析了老年患者出院后的药物清单，发现 83%的患者存在 DRP。随后，根据临床案例场景评估了医生识别 DRP 的能力。这些临床案例场景包括适用的药物史，并提供了有针对性的药物信息。在这些条件下，医生识别出了许多定义明确的 DRP。
