A comprehensive medication review of a polypharmacy patient population: A cross-sectional observational study

Abstract

BackgroundIt is well documented that polypharmacy status is associated with manifold drug-related problems (DRPs). In this cross-sectional observational study, a type 1 medication review of a polypharmacy patient population in Greece was carried out. ObjectivesThe study aim was to quantify the prevalence of unaddressed DRPs in a representative Greek polypharmacy patient population. The secondary aim was to report on the average monthly medication cost per polypharmacy study patient. MethodsThe study population consisted of 91 older, high-risk polypharmacy patients registered at 10 community pharmacies in Athens. The cross-sectional medication review was conducted by 10 independent pharmacists during September of 2020. DRPs were assessed and classified according to ‘The PCNE Classification V 5.01’ by two clinical pharmacists and researchers. ResultsA median concurrent use of 8.45 medications per patient was found, with an average of 1.89 identified DRPs per study subject. A total of 172 DRPs were observed in the study population. 75.6% of all DRPs were classified as drug-drug interaction problems, with a mean of 1.42 identified drug-drug interactions per study subject. The mean monthly cost per polypharmacy patient was calculated at €38.64 ($45.20 USD). ConclusionThere is urgent need to improve in-pharmacy medication monitoring and advising to optimize drug concordance and to reduce DRPs among polypharmacy patients in Greece. Further research is warranted to investigate larger scale polypharmacy-related iatrogenic harm potential due to overlooked and unaddressed DRPs within Europe and globally. Investigation into the predictors of and risk factors for DRP incidence in polypharmacy patient populations is also needed. Broadly, this study underscores the need for continuous and perspicacious monitoring of unaddressed DRPs in patients using multiple drugs by community pharmacists.