Department of Pharmacy, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
Adv Clin Exp Med. 2023 Apr;32(4):423-432. doi: 10.17219/acem/155372.
Ischemic stroke incidence is increasing amongst elderly patients in China; this is closely associated with drug-related problems (DRPs).
To evaluate the influencing factors of DRPs among elderly patients with a history of ischemic stroke in the Chinese community and the role clinical pharmacists play in providing solutions.
This study was conducted in 2 community health service centers in Putuo District, Shanghai, China, between December 2018 and June 2019. Demographics and clinical characteristics of the 130 selected patients were collected. Drug-related problems were classified using the Pharmaceutical Care Network Europe (PCNE)-DRP V8.03 classification system. The number, types, causes, interventions, and status of DRPs were then analyzed.
The average number of DRPs per patient was 1.3, corresponding to 256 causes. "Treatment effectiveness P1" was identified as the most common problem (75.0%). The main causes were "drug selection C1" (33.2%) and "patient-related C7" (30.9%). Antihypertensive drugs, statins, aspirin, and Chinese patent medicines were the top 4 drugs for DRPs. Age, unintentional medication discrepancy and medication compliance were independent predictors of DRPs. Pharmacists provided 339 interventions, mainly "at drug level I3" (38.9%) and "at patient level I2" (30.7%). Most of the interventions (85.5%) were accepted by the patients and 65.9% of the problems were solved.
The number, types and etiology of DRPs in elderly patients with ischemic stroke in our community are diverse and treatment effectiveness is the main cause of their occurrence. Clinical pharmacists play an important role in providing interventions for major causes of DRPs.
在中国，老年缺血性脑卒中患者的发病率正在上升；这与药物相关问题（DRP）密切相关。
评估中国社区老年缺血性脑卒中患者的 DRP 影响因素，以及临床药师在提供解决方案方面的作用。
本研究于 2018 年 12 月至 2019 年 6 月在上海市普陀区 2 家社区卫生服务中心进行。收集了 130 名入选患者的人口统计学和临床特征。使用欧洲药学保健网络（PCNE）-DRP V8.03 分类系统对药物相关问题进行分类。然后分析了药物相关问题的数量、类型、原因、干预措施和解决情况。
每位患者的平均药物相关问题数为 1.3 个，对应 256 个原因。“治疗效果 P1”被确定为最常见的问题（75.0%）。主要原因是“药物选择 C1”（33.2%）和“患者相关 C7”（30.9%）。降压药、他汀类药物、阿司匹林和中药是发生药物相关问题的前 4 位药物。年龄、非故意药物差异和药物依从性是药物相关问题的独立预测因素。药师提供了 339 项干预措施，主要是“药物层面 I3”（38.9%）和“患者层面 I2”（30.7%）。大多数干预措施（85.5%）被患者接受，65.9%的问题得到解决。
本社区老年缺血性脑卒中患者的药物相关问题数量、类型和病因多种多样，治疗效果是其发生的主要原因。临床药师在提供药物相关问题主要原因的干预措施方面发挥着重要作用。
