Abstract
PurposeThe complex combination of medicines associated with age-related physiological alterations leads older adults to experience drug-related problems (DRPs). The goal of this study was to review the frequency and type of DRPs and DRP risk factors in home-dwelling older adults. MethodsA MEDLINE PubMed and EMBASE scientific databases search was performed. Articles published from January 2000 through December 2018 reporting DRPs in home-dwelling older adults were included. FindingsFrom 668 articles screened, 13 met the inclusion criteria and were included in this study. Overall, the studies included 8935 home-dwelling patients. The mean number of DRPs per patient observed was 4.16 (1.37–10). The main causes of DRPs were “drug selection” (51.41%), “dose selection” (11.62%), and “patient related” (10.70%) problems. The drug classes more frequently associated with DRPs were “cardiovascular system,” “alimentary tract and metabolism,” and “nervous system,” and they represented 32.1%, 29.4%, and 16.5% of all drug selection problems, respectively. Respiratory system medicines accounted for 6.65% of all DRPs, of which “patient related” problems accounted for 97.28%. ImplicationsDespite the heterogeneity of methodology of the included studies and the heterogeneity of tools used to identify DRPs, this analysis clearly shows the high prevalence of DRPs in home-dwelling older adults and highlights the need for interventions to improve medicine use in this population. This work also provides useful information for the development of strategies to improve medication use in home-dwelling older adults.
Highlights
The World Health Organization (WHO) estimates that >50% of all medicines are prescribed, dispensed, or sold inappropriately, and more than one half of patients fail to take them properly.[1]
The following search terms were used: “drug-related problems” AND “elderly” OR “drugrelated problems” AND “older” OR “medicationrelated-problems” AND “older” OR “medicationrelated problems” AND “elderly.” Research studies were eligible for inclusion if they were in accordance with the following selection criteria: (1) language; (2) target population; and (3) outcome measures (DRPs in home-dwelling adults)
To avoid the selection bias associated with patients who are not representative of an older population, studies were excluded if their focus was to evaluate Drug-related problems (DRPs) with a specific medical condition or a specific nature of DRPs.[7]
Summary
The World Health Organization (WHO) estimates that >50% of all medicines are prescribed, dispensed, or sold inappropriately, and more than one half of patients fail to take them properly.[1] Drug-related problems (DRPs) are responsible for an increased risk of hospital admissions and emergency department. Clinical Therapeutics visits.[2] adverse drug events account for >3.7% of all hospital admissions. Medication nonadherence and monitoring problems account for 31% and 22%, respectively, of preventable drugrelated admissions.[3]. Older adults are more likely to take multiple medications and metabolize medications differently than younger adults, and this may exacerbate DRPs as well as drug-related hospital admissions.[2,4] In the last decade, several strategies have failed the attempt to improve elderly patient well-being and reduce health care costs[5]; these patients account for 15%e30% of all drug-related hospital admissions.[6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
