Abstract
Drug-related problems (DRP) cause preventable negative health outcomes, especially during hospital admissions. The aim of our study was to examine the prevalence and characteristics of DRP in regular clinical pharmacy, as well as to determine those factors associated with a higher risk of DRP in the hospital setting. We analyzed data from a standardized registry database of regular pharmacy practice (2015- 2016). DRP were classified according to the Pharmaceutical Care Network Europe v6.2 classification. Cross-sectional data were obtained from 1602 adults admitted to medical wards. Crude and adjusted binary logistic regressions were performed to identify associations between potential risk factors and DRP. Overall DRP prevalence was high across medical specialties (45,1%), in a population characterized by advanced age, polypharmacy and multimorbidity. Problems leading to DRP were mainly classified into two domains (effectiveness and adverse reactions), being drug and dose selection the most frequent causes. Interventions were accepted and DRP were totally or partially solved in 74.1% and 4.81% of cases, respectively. In the adjusted model polypharmacy, allergies, BMI > 25 kg/m2 and clearance < 30 mL/min were associated with a higher risk of DRP. The participation of clinical pharmacists into multidisciplinary teams promotes the detection and solution of DRP. Polypharmacy, obesity, renal impairment and allergy are associated with a higher risk of DRP during admission.
Highlights
Drug-related problems (DRP) cause preventable negative health outcomes, especially during hospital admissions
We found a high prevalence of DRP, most being caused by drug or dose selection, in a sample that highlights the worldwide demographical trends of ageing along with multimorbidity and polypharmacy
Pharmacist interventions were accepted in most cases, preventing potential negative health outcomes
Summary
Drug-related problems (DRP) cause preventable negative health outcomes, especially during hospital admissions. Pharmacotherapy has been associated with negative health outcomes such as adverse effects, interactions, adherence problems, functional decline, cognitive problems, falls, urinary incontinence and metabolic or nutritional problems[6,7,8,9,10,11,12,13] The risk of these problems increases with the number of drugs. Several factors may significantly increase the risk of suffering a drug-related problem (DRP), defined as “an event or circumstance involving drug therapy that or potentially interferes with desired health outcomes”[19] as previously described, for example, in experiences of care transitions across the continuum of care[20,21]. Activities in real clinical practice are neither homogeneous nor standardized and data collection, such as the prevalence or the characterization of DRPs, is unusual
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