Influence of pharmacist intervention on drug safety of geriatric inpatients: a prospective, controlled trial
Nachtigall A, Heppner HJ, Thuermann PA (2019)
Publication Type: Journal article
Publication year: 2019
Journal
Book Volume: 10
Abstract
Background: Demographic shift leads to an increasing number of geriatric patients suffering from multimorbidity and resulting polypharmacy. Polypharmacy is shown to be associated with drug-related problems (DRPs) and increased morbidity. For Germany, a hospital-based intervention may be successful optimizing of polypharmacy. The aim of this study was to reduce DRPs in geriatric inpatients by a structured pharmacist's intervention and to measure the acceptance rate of pharmaceutical recommendations. Methods: This study followed an open, prospective, quasi-randomized, controlled design and was conducted in a geriatric department in a teaching hospital in Germany. Patients of all sexes were included, with a minimum age of 70 years, a written informed consent and a regular intake of at least five drugs daily. Primary outcome was the percentage of patients having a DRP at admission and discharge. A DRP was defined as a prescription without indication or a relevant drug-drug interaction or prescription of a potentially inappropriate medication or presence of an adverse drug reaction. Recommendations were classified and discussed face to face. Statistical analyses were performed using a full-set analysis and a matched-pairs design. Results: Within 12 months, 411 patients were recruited with median age of 82 years (intervention: n = 209; control: n = 202). Median number of drugs at admission was 10 (range 5-24), at discharge 9 (range 3-21). In the intervention group, the percentage of patients with a DRP was reduced from 86.6% to 56.0%; in the control group, from 76.7% to 76.2% (p value < 0.001). Medication appropriateness index score was reduced by 56% in the intervention group and by 0.2% in the control group (p value < 0.001). Implementation rate of the pharmaceutical recommendation was 80%. Conclusion: This prospective controlled trial showed that a pharmacist's intervention was successful in optimizing polypharmacy in geriatric inpatients.
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Germany (DE)How to cite
APA:
Nachtigall, A., Heppner, H.J., & Thuermann, P.A. (2019). Influence of pharmacist intervention on drug safety of geriatric inpatients: a prospective, controlled trial. Therapeutic Advances in Drug Safety, 10. https://dx.doi.org/10.1177/2042098619843365
MLA:
Nachtigall, Angela, Hans Jürgen Heppner, and Petra A. Thuermann. "Influence of pharmacist intervention on drug safety of geriatric inpatients: a prospective, controlled trial." Therapeutic Advances in Drug Safety 10 (2019).
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