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

Int J Clin Pharm. 2018 Apr;40(2):368-375. doi: 10.1007/s11096-017-0587-3. Epub 2018 Jan 16.

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.

Keywords: China; Community-dwelling older adults; Drug-related problems; Medication therapy review; Pharmacists.

MeSH terms

  • Aged
  • China / epidemiology
  • Community Health Centers / trends*
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Drug-Related Side Effects and Adverse Reactions / prevention & control*
  • Female
  • Humans
  • Independent Living / trends*
  • Male
  • Medication Reconciliation / methods
  • Medication Reconciliation / trends
  • Pharmacists*
  • Polypharmacy
  • Professional Role*
  • Prospective Studies