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13. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

02.11. bis 03.11.2006, Berlin

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Drug-related problems in nursing homes - a prospective survey

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  • corresponding author F. Hanke - Institute of Clinical Pharmacology, HELIOS Klinikum Wuppertal, University Witten/Herdecke, Germany
  • J. Szymanski - Institute of Clinical Pharmacology, HELIOS Klinikum Wuppertal, University Witten/Herdecke, Germany
  • U. Jaehde - Institute of Clinical Pharmacy, Rheinische Friedrich-Wilhelms-University, Bonn, Germany
  • P.A. Thürmann - Institute of Clinical Pharmacology, HELIOS Klinikum Wuppertal, University Witten/Herdecke, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 13. Jahrestagung der Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie. Berlin, 02.-03.11.2006. Düsseldorf: German Medical Science GMS Publishing House; 2006. Doc06gaa07

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gaa2006/06gaa07.shtml

Veröffentlicht: 30. Oktober 2006

© 2006 Hanke 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

Context: Polypharmacotherapy is a common problem in nursing home residents (NHR) and has been associated with an increased risk of drug-related problems (DRP) and adverse reactions, e.g. falls and hospital admissions. The study is an integral part of the OPAL – Project including independent examinations about pharmacoepidemology, prevention strategies and out-comes concerning DRPs in nursing homes.

Aim of Study: In an open, prospective study we documented and analysed the frequency and type of DRP in NHR according to their clinical relevance, pharmacoeconomic consequences and preventability.

Material and Methods: A geriatric pharmacist screened all medical records and interviewed the nursing home staff. DRP were classified by the PCNE–Codex, for adverse drug reactions causality assessment was performed according to WHO criteria and an expert panel determined the preventability of the DRP.

Results: During 10 months 89 NHR (15% male, mean age 85 yrs., range 67–98 yrs.) were observed of whom 66 suffered from 163 DRP (incl. 42 ADRs). Major problems were: dosing errors, drug interactions and improper drug selection (modified Beer’s criteria). 64% of the ADR were classified as potentially preventable. Anti-psychotic and cardiovascular drugs were the most common medications causing DRP. ADRs resulted in more than 1,100 additional nursing staff working hours and 50 days of hospital stay.

Conclusion: DRPs -respectively ADRs are common in NHR. More then 50% of the clinically relevant DRPs were determined preventable. Pharmaceutical care strategies should similarly enfold physicians, pharmacists and nursing home staff particularly with regard to monitor the process of pharmacotherapy.

Supported by Robert-Bosch-Foundation and Paul-Kuth-Foundation.