Artikel
Medication Safety of Elderly Hospitalized Patients
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Autoren
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Rebekka Lenssen
- Hospital Pharmacy, University Hospital Aachen, Aachen, Germany
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Axel Heidenreich
- Department of Urology, University Hospital Aachen, Aachen, Germany
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Jörg Bernhard Schulz
- Department of Neurology, University Hospital Aachen, Aachen, Germany
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Christian Trautwein
- Department of Internal Medicine III, Gastroenterology, University Hospital Aachen, Aachen, Germany
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Ulrich Jaehde
- Department of Clinical Pharmacy, Institute of Pharmacy, University of Bonn, Bonn, Germany
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Albrecht Eisert
- Hospital Pharmacy, University Hospital Aachen, Aachen, Germany
| Veröffentlicht: | 25. November 2013 |
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Gliederung
Text
Background: Medication safety is an essential part of patient safety. Pharmaceutical care is one way to improve medication safety by solving drug-related problems (DRP).
For elderly patients, potentially inappropriate medications (PIM) are defined in the so-called PRISCUS list [1]. Such drugs might be a risk factor for adverse drug reactions [1]. A pilot study was conducted to reveal the necessity of pharmaceutical care services on different wards at RWTH Aachen University Hospital [2]. In addition, the occurrence of PIM in medication profiles was measured.
Materials and Methods: A pharmaceutical care service was provided on the cooperating wards for patients of all age, for an approximately three-months-period, respectively. Drug-related problems at each step of the medication process were identified and solved by a clinical pharmacist. They were classified using the APS-Doc system [3].
In analysing these DRP, patients were divided in two groups of age (<65 years and ≥65 years old). The number of PIM was taken from the medication profiles of the elderly. The three-months-prevalence was calculated and additional statistical analyses were performed.
The project was approved by the local ethics committee.
Results: On average, 2.3 DRP per patient were documented. Elderly patients (≥65 years) had significantly more drug-related problems than younger ones (2.5 vs. 1.9 DRP, p<0.05) [2].
The three-months-prevalence indicated that one of two elderly patients received at least one PIM. Psycholeptics (e.g. benzodiazepines, zopiclone, zolpidem) were found frequently in the medication profiles.
These results underline the need for pharmaceutical care, in particular for elderly patients.
Thus, we are currently conducting a randomised controlled study to evaluate the benefit of pharmaceutical care for elderly patients.
Conclusion: Elderly patients are more vulnerable for drug-related problems and should receive pharmaceutical care services, in particular. Due to the high prevalence of potentially inappropriate medications health-care professionals should be aware of the possible problems induced by these drugs.
We gratefully thank the Apothekerstiftung Nordrhein, Duesseldorf and the Foerderinitiative Pharmazeutische Betreuung e.V., Berlin for funding the project.
Authors are entirely independent.
References
- 1.
- Holt S, Schmiedl S, Thürmann PA. Potentially inappropriate medications in the elderly: the PRISCUS list. Dtsch Arztebl Int. 2010 Aug;107(31-32):543-51. DOI: 10.3238/arztebl.2010.0543
- 2.
- Lenssen R, et al. Medication safety at a German University Hospital—results of a pilot project. Int J Clin Pharm. 2013;35:494-5.
- 3.
- Hohmann C, Eickhoff C, Klotz JM, Schulz M, Radziwill R. Development of a classification system for drug-related problems in the hospital setting (APS-Doc) and assessment of the inter-rater reliability. J Clin Pharm Ther. 2012 Jun;37(3):276-81. DOI: 10.1111/j.1365-2710.2011.01281.x
