Chivapricha Wajanakorn, Srinonprasert Varalak, Suansanae Thanarat
College of Pharmacy, Rangsit University, Pathumthani, Thailand.
Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Drugs Real World Outcomes. 2021 Mar;8(1):39-47. doi: 10.1007/s40801-020-00214-7. Epub 2020 Oct 15.
Elderly patients are at greater risk of receiving potentially inappropriate medications (PIMs) and developing adverse drug events. Identification and correction of PIMs is essential to maximize medication safety.
To determine the prevalence of PIMs on admission in Thai elderly patients admitted to a medical ward and to compare changes of PIMs on discharge, following comprehensive care by a ward pharmacist with or without a geriatric pharmacy specialist.
A prospective, quasi-experimental study was performed at a tertiary university hospital in Bangkok, Thailand. Patients aged ≥ 60 years who were admitted to the medical ward were recruited and allocated to one of two groups: intervention (IG) and control (CG). The CG received pharmaceutical care from the ward pharmacist. The IG received pharmaceutical care from the geriatric pharmacy specialist along with the ward pharmacist. The 2012 Beers criteria were used to identify PIMs on admission, during hospitalization, and on discharge.
Prevalence of PIMs on admission was 43.3% (N = 187). On discharge, prevalence of PIMs in the IG decreased significantly compared to that on admission (21.3% and 43.3%, p < 0.05) and was significantly lower than in the CG (21.3% and 40.9%, p = 0.036). Moreover, the percentage of patients without PIMs on discharge in the IG was significantly higher than in the CG (78.7% and 59.1%, p < 0.0001).
Use of PIMs was common among hospitalized elderly patients on admission. Pharmaceutical care provided by a geriatric pharmacy specialist in conjunction with a ward pharmacist significantly reduced the prevalence of PIMs on discharge compared with on admission.
老年患者服用潜在不适当药物（PIMs）及发生药物不良事件的风险更高。识别并纠正PIMs对于最大限度提高用药安全性至关重要。
确定入住泰国一家内科病房的老年患者入院时PIMs的患病率，并比较在有或没有老年药学专家参与的情况下，经病房药师进行综合护理后出院时PIMs的变化情况。
在泰国曼谷的一家三级大学医院进行了一项前瞻性、准实验性研究。招募入住内科病房且年龄≥60岁的患者，并将其分为两组：干预组（IG）和对照组（CG）。CG接受病房药师的药学服务。IG接受老年药学专家和病房药师共同提供的药学服务。采用2012年Beers标准来识别入院时、住院期间及出院时的PIMs。
入院时PIMs的患病率为43.3%（N = 187）。出院时，IG中PIMs的患病率与入院时相比显著降低（分别为21.3%和43.3%，p < 0.05），且显著低于CG（分别为21.3%和40.9%，p = 0.036）。此外，IG中出院时无PIMs的患者百分比显著高于CG（分别为78.7%和59.1%，p < 0.0001）。
住院老年患者入院时使用PIMs的情况很常见。与入院时相比，老年药学专家联合病房药师提供的药学服务显著降低了出院时PIMs的患病率。
