gms | German Medical Science

24th Annual Meeting of the German Drug Utilisation Research Group (GAA)

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

30.11. - 01.12.2017, Erfurt

Identification of drug-related problems by means of pharmacy-based medication review – results of a project to optimise medication safety

Meeting Abstract

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Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 24. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Erfurt, 30.11.-01.12.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. Doc17gaa89

doi: 10.3205/17gaa89, urn:nbn:de:0183-17gaa890

Published: December 5, 2017

© 2017 Sell et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Background: Medication safety is a major health concern, especially for the elderly population, in which drug-related problems (DRPs) have been shown to occur more frequently. Along with common polypharmacy and frailty, this elevates the risk to suffer adverse drug events. Therefore, it is important to gain additional insight into potential risks of different patient groups to tailor pharmacy-based safety measures more efficiently.

Materials and Methods: Over the course of one week in spring 2015, medication reviews for primary care patients were conducted by 300 public pharmacies in the German federal state of Saxony-Anhalt. Patients were asked to bring their complete medication to the pharmacy for analysis (“brown bag review”). Pharmacists recorded the medication and aimed to identify and solve DRPs with patients and, if necessary, their physicians and thereby improve medication safety. Data from these reviews were collected by the chamber of pharmacists of Saxony-Anhalt and analysed by the authors. This included patient and drug therapy characteristics, data on the review process and on the frequency and nature of DRPs and their respective solutions.

Results: 1090 patients participated in the review process, 52.0% of which were female and 64.9% possessed medication lists. On average, patients were 72 years old and had 10.6 medications, higher numbers were found for female and older patients. 31.7% of patients did not know the purpose of at least one medication, the ratio grew among male and older patients. Most prominent indication areas according to the ATC-classification included cardiovascular drugs (36.0%), drugs for the alimentary system and metabolism (20.0%) and drugs affecting the nervous system (11.5%). For 83.3% of the patients, at least one DRP was identified (overall 4460 DRPs in 3707 medications). Problems were categorised according to the PIE-Doc®-classification, prevalence was highest for drug-drug-interactions (53.7%) and problems concerning drug application and adherence (46.7%), the latter of which was higher in older patients and patients without medication lists. 72.2% of the problems could be resolved between pharmacist and patient, in 12.7% physicians had to be contacted. For the review procedure, an average duration of 66.7 min was documented, however, time-spans varied greatly and increased with the number of medications and identified DRPs.

Conclusion: Depending on the nature of the respective problem, patient risk factors included a high number of medications, lack of knowledge about drug indications, lack of a medication list and an age of 75 years or older. The total number of DRPs was not associated with age, sex or the existence of a medication list, it did, however, correlate with the number of medications. Thus, patients with these risk-factors will particularly benefit from interventions to optimise drug therapy.