Department of Pharmacy, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Clinical Pharmacy, School of Pharmacy, College Health Science University of Gondar, Gondar, Ethiopia.
Biomed Res Int. 2022 Jul 18;2022:8742998. doi: 10.1155/2022/8742998. eCollection 2022.
Drug therapy in the elderly needs an emphasis on age-related changes in drug pharmacokinetics and pharmacodynamics profile. Hospitalized elderly patients are at risk of more than one disease and polypharmacy associated with these; they are at risk of drug-related problems. This study aimed to assess the role of clinical pharmacy on identifying and resolution of drug-related problems among elderly patients admitted to medical ward of Northwest Ethiopia comprehensive specialized hospitals. : A multicenter prospective observational study was conducted. A systematic sampling technique was used. The identified drug-related problem was recorded and classified using Cipolle, and adverse drug reaction was assessed using Naranjo algorithm of adverse drug reaction probability scale, and Medscape was used for drug-drug interaction. Data were analyzed by using STATA software version 14.1. Logistic regression was used, and results were reported as odds ratios (ORs) with 95% Confidence intervals with value < 0.05 statistically significant. : A total of 389 study participants were included in the study. About 266 (68.4%) of the participants had at least a single drug-related problem. About 503 drug-related problems were identified with a mean of 1.32 (CI: 1.27-1.36) drug-related problem per patient. The three-leading categories of drug-related problems were dose too high 108 (21.5%), nonadherence 105 (20.9%), and adverse drug reaction 96 (19.1%). Alcohol use (AOR = 2.2, 95CI%: 1.23-3.94), source of the drug (AOR = 2.85, 95CI%: 1.63-4.98), length of hospitalization (AOR = 2.32, 95CI%: 1.37-3.95), number of comorbidities (AOR = 1.48, 95CI%: 1.09-1.99), and polypharmacy (AOR = 3.06, 95CI%: 1.72-5.46) were important risk factors for drug-related problems. From the intervention provided, 84.7% were accepted by prescribers. Among the total drug-related problems 67.4% of the problem was totally solved. : This study revealed that DRPs were high among elderly patients admitted to medical ward of Northwest Ethiopia. Comorbidity, length of hospitalization, ploy-pharmacy, payer, and alcohol drinker were more likely to developed drug-related problems. Treatment optimizations were also done by clinical pharmacists and interventions were well accepted by prescribers.
老年人的药物治疗需要强调药物药代动力学和药效学特征与年龄相关的变化。住院的老年患者不止有一种疾病,并且与这些疾病相关的多种药物治疗也会带来风险;他们存在药物相关问题的风险。本研究旨在评估临床药学在识别和解决西北埃塞俄比亚综合专科医院内科病房老年患者药物相关问题方面的作用。
一项多中心前瞻性观察性研究。采用系统抽样技术。记录并使用 Cipolle 分类识别到的药物相关问题,使用 Naranjo 药物不良反应概率量表评估药物不良反应,使用 Medscape 评估药物-药物相互作用。使用 STATA 软件版本 14.1 进行数据分析。使用逻辑回归,结果以比值比(OR)表示,95%置信区间,p 值<0.05 具有统计学意义。
共纳入 389 名研究参与者。约 266 名(68.4%)参与者至少存在一种药物相关问题。共发现 503 种药物相关问题,每位患者平均存在 1.32(CI:1.27-1.36)种药物相关问题。药物相关问题的三个主要类别是剂量过高 108 例(21.5%)、不遵医嘱 105 例(20.9%)和药物不良反应 96 例(19.1%)。饮酒(OR = 2.2,95CI%:1.23-3.94)、药物来源(OR = 2.85,95CI%:1.63-4.98)、住院时间(OR = 2.32,95CI%:1.37-3.95)、合并症数量(OR = 1.48,95CI%:1.09-1.99)和多种药物治疗(OR = 3.06,95CI%:1.72-5.46)是药物相关问题的重要危险因素。提供的干预措施中,84.7%被开处方者接受。在所有药物相关问题中,67.4%的问题得到完全解决。
本研究表明,西北埃塞俄比亚内科病房住院老年患者的药物相关问题发生率较高。合并症、住院时间、多种药物治疗、付款方式和饮酒者更容易出现药物相关问题。临床药师还进行了治疗优化,干预措施得到了开处方者的认可。