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Drug-related problems among community-dwelling older adults in mainland China

  • Research Article
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Abstract

Background Little is known about the extent of drug-related problems (DRPs) in community-dwelling older adult patients with chronic diseases in mainland China. Setting A medication therapy review service at a community health center in Chongqing, China. Objective To identify and categorize DRPs along with pharmacists’ recommendations in addressing the DRPs identified. Method The study was conducted between May 2015 and July 2016. A total of 102 community-dwelling older adults were included. MTR was carried out by clinical pharmacists. DRPs and pharmacotherapy recommendations were recorded and analyzed. Main outcome measure The number of drug-related problems and main problem categories. Results The average age of patients was 69.4 years. Patients took an average of 6.3 medications. A total of 489 DRPs were identified (mean of 4.8 per patient). The most common category was under-treated (27.8%) followed by over- or under-dose (18.8%) and monitoring (17.8%). The number of medications taken was the significant associated factor for DRPs. Pharmacists made 526 recommendations to address the DRPs (mean of 1.1 recommendations per DRP). Primary care providers accepted 68.1% of these recommendations, and implemented 60.9% of them. Conclusion The prevalence of DRPs among studied patient population was high. Pharmacists may play a vital role in addressing the DRPs and optimize pharmacotherapy through MTR service located in community health centers.

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References

  1. Xiao N, Long Q, Tang X, Tang S. A community-based approach to non-communicable chronic disease management within a context of advancing universal health coverage in China: progress and challenges. BMC Public Health. 2014;14(2):1.

    CAS  Google Scholar 

  2. Yach D, Hawkes C, Gould CL, Hofman KJ. The global burden of chronic diseases: overcoming impediments to prevention and control. JAMA J Am Med Assoc. 2004;291(21):2616–22.

    Article  CAS  Google Scholar 

  3. Skinner JS, Poe B, Hopper R, Boyer A, Wilkins CH. Assessing the effectiveness of pharmacist-directed medication therapy management in improving diabetes outcomes in patients with poorly controlled diabetes. Diabetes Educ. 2015;41(4):387–95.

    Article  Google Scholar 

  4. Carter BL, Coffey CS, Ardery G, Uribe L, Ecklund D, James P, et al. Cluster-randomized trial of a physician/pharmacist collaborative model to improve blood pressure control. Circ Cardiovasc Qual Outcomes. 2015;8(3):418–23.

    Article  Google Scholar 

  5. Greer N, Bolduc J, Geurkink E, Rector T, Olson K, Koeller E, et al. Pharmacist-led chronic disease management: a systematic review of effectiveness and harms compared with usual care. Ann Internal Med. 2016;165(1):1–27.

    Article  Google Scholar 

  6. Graabaek T, Kjeldsen LJ. Medication reviews by clinical pharmacists at hospitals lead to improved patient outcomes: a systematic review. Basic Clin Pharmacol Toxicol. 2013;112(6):359–73.

    Article  CAS  PubMed  Google Scholar 

  7. Pharmaceutical Care Network Europe (PCNE). Classification for Drug related problems V5.01. http://www.pcne.org/dokumenter/DRP/PCNE%20classification%20V5.01.pdf. Accessed 19 June 2016.

  8. Kaufmann CP, Stampfli D, Hersberger KE, Lampert ML. Determination of risk factors for drug-related problems: a multidisciplinary triangulation process. BMJ Open. 2015;5(3):e006376.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Roughead EE, Semple SJ. Medication safety in acute care in Australia: where are we now? Part 1: a review of the extent and causes of medication problems 2002–2008. Aust N Z Health Policy. 2009;6(1):1.

    Article  Google Scholar 

  10. WHO Collaborating Centre for Drug Statistics Methodology. The anatomical therapeutic chemical (ATC) classification system. http://www.whocc.no/atc/structure_and_principles/. Accessed 19 June 2016.

  11. Xiong X, Wang P, Zhang Y, Li X. Effects of traditional Chinese patent medicine on essential hypertension: a systematic review. Medicine. 2015;94(5):e442.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Williams M, Peterson GM, Tenni PC, Bindoff IK, Stafford AC. DOCUMENT: a system for classifying drug-related problems in community pharmacy. Int J Clin Pharm. 2012;34(1):43–52.

    Article  PubMed  Google Scholar 

  13. Gheewala PA, Peterson GM, Curtain CM, Nishtala PS, Hannan PJ, Castelino RL. Impact of the pharmacist medication review services on drug-related problems and potentially inappropriate prescribing of renally cleared medications in residents of aged care facilities. Drugs Aging. 2014;31(11):825–35.

    Article  PubMed  Google Scholar 

  14. Kwint HF, Faber A, Gussekloo J, Bouvy ML. Effects of medication review on drug-related problems in patients using automated drug-dispensing systems: a pragmatic randomized controlled study. Drugs Aging. 2011;28(4):305–14.

    Article  PubMed  Google Scholar 

  15. Koh Y, Kutty FB, Li SC. Drug-related problems in hospitalized patients on polypharmacy: the influence of age and gender. Ther Clin Risk Manage. 2005;1(1):39–48.

    Article  Google Scholar 

  16. Stegemann S, Ecker F, Maio M, Kraahs P, Wohlfart R, Breitkreutz J, et al. Geriatric drug therapy: neglecting the inevitable majority. Ageing Res Rev. 2010;9(4):384–98.

    Article  PubMed  Google Scholar 

  17. Chan DC, Chen JH, Wen CJ, Chiu LS, Wu SC. Effectiveness of the medication safety review clinics for older adults prescribed multiple medications. J Formos Med Assoc. 2014;113(2):106–13.

    Article  PubMed  Google Scholar 

  18. Chan DC, Chen JH, Kuo HK, We CJ, Lu IS, Chiu LS, et al. Drug-related problems (DRPs) identified from geriatric medication safety review clinics. Arch Gerontol Geriatr. 2012;54(1):168–74.

    Article  PubMed  Google Scholar 

  19. Bell JS, Whitehead P, Aslani P, McLachlan AJ, Chen TF. Drug-related problems in the community setting: pharmacists’ findings and recommendations for people with mental illnesses. Clin Drug Investig. 2006;26(7):415–25.

    Article  PubMed  Google Scholar 

  20. Austin RP. Polypharmacy as a risk factor in the treatment of type 2 diabetes. Diabetes Spectr. 2006;19(1):13–6.

    Article  Google Scholar 

  21. Viktil KK, Blix HS, Moger TA, Reikvam A. Polypharmacy as commonly defined is an indicator of limited value in the assessment of drug-related problems. Br J Clin Pharmacol. 2007;63(2):187–95.

    Article  PubMed  Google Scholar 

  22. Hsu WT, Shen LJ, Lee CM. Drug-related problems vary with medication category and treatment duration in Taiwanese heart failure outpatients receiving case management. J Formos Med Assoc. 2016;115(5):335–42.

    Article  PubMed  Google Scholar 

  23. Kjeldsen LJ, Birkholm T, Fischer H, Graabaek T, Kibsdal KP, Ravn-Nielsen LV, et al. Characterization of drug-related problems identified by clinical pharmacy staff at Danish hospitals. Int J Clin Pharm. 2014;36(4):734–41.

    Article  PubMed  Google Scholar 

  24. Zaman Huri H, Chai Ling L. Drug-related problems in type 2 diabetes mellitus patients with dyslipidemia. BMC Public Health. 2013;13:1192.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hsu S, Ton VK, Dominique Ashen M, Martin SS, Gluckman TJ, Kohli P, et al. A clinician’s guide to the ABCs of cardiovascular disease prevention: the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease and American College of Cardiology Cardiosource Approach to the Million Hearts Initiative. Clin Cardiol. 2013;36(7):383–93.

    Article  PubMed  Google Scholar 

  26. Tulner LR, van Campen JP, Frankfort SV, Koks CH, Beijnen JH, Brandjes DP, et al. Changes in under-treatment after comprehensive geriatric assessment: an observational study. Drugs Aging. 2010;27(10):831–43.

    Article  PubMed  Google Scholar 

  27. Gilbert AL, Roughead EE, Beilby J, Mott K, Barratt JD. Collaborative medication management services: improving patient care. Med J Aust. 2002;177(4):189–92.

    PubMed  Google Scholar 

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Acknowledgements

We would like to thank Ms. Ling Luo, Ms. Yuying Luo, Ms. Li Lin and other nurses/pharmacists for participants’ enrollment and data collection. We also thank Dr. Jia Yang, Dr. Leju Chen and other physicians for referring their patients to our study.

Funding

This project was funded by the Chongqing Science & Technology Commission, Grant Number: cstc2015shmszx0592 and Natural Science Foundation of China, Grant Number: 81603330.

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    Authors and Affiliations

    1. Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China

      Jiadan Yang, Long Meng, Yu Liu, Rui Long, Xuefeng Shan, Jie Song & Feng Qiu

    2. Community Health Center of Nanshan Street Nanan District, Chongqing, 400065, China

      Liping Lv

    3. College of Pharmacy and Health Sciences, Western New England University, Springfield, MA, 01119, USA

      Shusen Sun

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    1. Jiadan Yang
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    Correspondence to Feng Qiu.

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    All the authors declare that they have no conflict of interest.

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    Jiadan Yang and Long Meng have contributed equally to this work.

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    Cite this article

    Yang, J., Meng, L., Liu, Y. et al. Drug-related problems among community-dwelling older adults in mainland China. Int J Clin Pharm 40, 368–375 (2018). https://doi.org/10.1007/s11096-017-0587-3

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    • DOI: https://doi.org/10.1007/s11096-017-0587-3

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