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19. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie (GAA)

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

22.11. - 23.11.2012, Jena

Drug-related problems in nursing homes – An interventional study to increase safety of pharmacotherapy and to reduce drug-costs

Arzneimittelbezogene Probleme in Alten- und Pflegeheimen – Eine Interventionsstudie zur Erhöhung der Arzneimitteltherapiesicherheit und zur Reduktion der Arzneimittelkosten

Meeting Abstract

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  • corresponding author Julia Kruse - WWU Münster, Institut für Pharmazeutische und Medizinische Chemie, Münster, Germany
  • author Isabel Waltering - Landeszentrum Gesundheit Nordrhein-Westfalen (LZG.NRW), Münster, Germany
  • author Udo Puteanus - Landeszentrum Gesundheit Nordrhein-Westfalen (LZG.NRW), Münster, Germany
  • author Georg Hempel - WWU Münster, Institut für Pharmazeutische und Medizinische Chemie, Münster, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 19. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Jena, 22.-23.11.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12gaa08

DOI: 10.3205/12gaa08, URN: urn:nbn:de:0183-12gaa082

Veröffentlicht: 14. November 2012

© 2012 Kruse et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Residents of nursing homes are prone to receive many different medications which could lead to different drug-related problems (DRP`s). The progressive multimorbidity in the aged requires a polypharmacotherapy. However, not in every case the drugs are compatible with each other. Drug-interactions, exceeding dosages and other drug-related problems can appear. The aim of this project was to establish a medication management by a pharmacist in nursing homes to analyse and solve drug-related problems and to improve the pharmacotherapy related to the age. Furthermore, a cost analysis was conducted in order to assess the effect of pharmaceutical care implementation on drug costs.

Materials and Methods: 209 residents of 7 nursing homes in Münster, Germany participated in this interventional study. Drug-related problems were measured and rated with the PIE-Doc-System®, which was specially adjusted to nursing homes. Over a period of two years each resident received a medication management. In this progress the identified drug-related problems were discussed and resolved by a pharmacist in cooperation with the prescribing doctors and nursing staff. Drug costs were measured before and 8–12 weeks after accomplishment.

Results: The residents had a median age of 86 years, 85.6% were female. The median intake of long-term-medication was 8, while 7 diagnoses were recorded. The most frequent documented diagnoses were dementia and hypertension. 1323 drug-related problems (DRP`s) were identified, in median each resident had 6 DRP’s. This includes cases in which the patients did not show symptoms, but the occurrence of side effects was expected. More than 77% of all DRP`s could be solved in cooperation with nursing staff and prescribing doctors. Drugs mostly involved in drug-related problems were proton-pump inhibitors, loop diuretics and different neuroleptics. The majority of DRP’s were drug-interactions (46.0%), followed by missing explicit indication (16.3%) and potentially prescribing omissions (14.0%).

Drug costs before medication management were 1161 Euro per day for all residents. There was a decrease of drug costs 8–12 weeks after pharmaceutical intervention to 1099 Euro per day (p<0.001). This is a median reduction of 0.70 Euro per resident per day.

Conclusion: In cooperation with other health care professionals the number of drug-related problems of nursing home residents could be reduced. Medication management could be used to optimise pharmacotherapy related to the age and to increase drug safety. A good and advanced communication between the different actors is necessary. Furthermore, drug costs could be reduced by establishing pharmaceutical care.