Drug-Related Problems among Hospitalized Surgical Elderly Patients in China

There is a lack of data on drug-related problems (DRPs) among elderly patients from surgical departments. The current study is aimed at identifying and categorizing types of DRPs and assessing the severities of the DRPs. Medication orders for hospitalized patients aged ≥65 years from six surgery departments were reviewed to determine DRPs over 6 months in a tertiary teaching hospital of Chongqing, China. DRPs were classified based on the Pharmaceutical Care Network Europe classification V8.02. The severity ratings of the DRPs were assessed using the National Coordinating Council for Medication Error Reporting and Prevention classification. A total of 53,231 medication orders from 1,707 elderly patients were reviewed, and 1,061 DRPs were identified. Treatment safety (44.9%) was the most common DRP type. Drug selection (43.1%) and dose selection (43.1%) were the major causes of DRPs. A total of 75.1% of the DRPs were classified into severity categories B to D (causing no or potential harm), and 24.9% were classified as categories E to H (causing actual harm). DRPs are common in hospitalized elderly surgical patients. Pharmacists should provide medication order reviews in this vulnerable patient population.

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Identification and solution of drug-related problems in the neurology unit of a tertiary hospital in China

BMC Pharmacology and Toxicology ◽

10.1186/s40360-021-00530-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Pengpeng Liu ◽

Guangyao Li ◽

Mei Han ◽

Chao Zhang

Keyword(s):

Tertiary Care ◽

Patient Treatment ◽

Major Type ◽

Drug Related Problems ◽

Dose Selection ◽

Nasogastric Feeding ◽

Factors Associated ◽

Clinical Pharmacists ◽

Medication Therapy ◽

Medication Error Reporting

Abstract Background The prevalence and characteristics of drug-related problems (DRPs) and factors associated with the occurrence of DRPs in the neurology unit in China remain unknown. This study aimed to determine the prevalence, characteristics and severity ratings of DRPs and identify factors associated with the occurrence of DRPs in the neurology unit of a tertiary care and academic teaching hospital in China. Methods A retrospective study of DRPs and pharmacists’ interventions for neurology patients was performed during a non-consecutive 24-month study period. Patient demographics and clinical characteristics, and pharmacist’s intervention records were collected. The characteristics and severity ratings of DRPs were categorized using the Pharmaceutical Care Network Europe (PCNE) DRP classification tool V9.00 and the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification respectively. Results A total of 242 DRPs were detected for 974 admitted patients, an average of 0.25 DRPs per patient. Treatment safety was the major type of DRPs (106;43.8%) followed by treatment effectiveness (78;32.2%). The primary causes of DRPs were drug selection (124;44.1%) and dose selection (92;32.7%). Clinical pharmacists provided 525 interventions, and most interventions occurred at the prescriber level (241;45.9%). A total of 91.4% of these interventions were accepted, contributing to solving 93.0% of the identified problems. The majority of DRPs (210;86.8%) were rated at severity categories B to D (causing no patient harm). Multiple logistic regression showed that creatinine clearance, number of medications used, nasogastric feeding, diabetes, and infectious diseases were associated with more frequent DRPs (p < 0.05). Conclusions DRPs are relatively common in the neurology unit in China, with primary causes of drug and dose selection, and clinical pharmacists can effectively reduce and prevent DRPs to optimize medication therapy.

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Drug-related problems among hospitalized patients with COPD in mainland China

International Journal of Clinical Pharmacy ◽

10.1007/s11096-019-00913-4 ◽

2019 ◽

Vol 41 (6) ◽

pp. 1507-1515 ◽

Cited By ~ 2

Author(s):

Qin Li ◽

Hui Jun Qu ◽

Dan Lv ◽

Ming-Kung Yeh ◽

Shusen Sun ◽

...

Keyword(s):

Mainland China ◽

Hospitalized Patients ◽

Drug Related Problems ◽

Dose Selection ◽

Patient Demographics ◽

Copd Patients ◽

Common Causes ◽

Academic Teaching Hospital ◽

Treatment Safety ◽

Exacerbation Of Copd

Abstract Background Data are lacking about the extent of drug-related problems in hospitalized patients with COPD in China. Objective Identify types and causes of drug-related problems and assess interventions performed by pharmacists. Setting Study was conducted in an academic teaching hospital in Shanghai, China. Method Between June 2017 and July 2018, 393 patients admitted to hospital for acute exacerbation of COPD hospitalized were enrolled. Patient demographics and clinical characteristics were collected. The drug-related problems and interventions were recorded and analyzed based on the Pharmaceutical Care Network Europe (PCNE)-DRP V 8.02 classification. Main outcome measures The number, types, causes, interventions, and outcomes of the problems were analyzed. Results A total of 640 DRPs, with 763 corresponding causes, were identified for 393 patients. “Treatment safety P2” was the most common type of problem (54.2%; 347/640), and the most common causes were “drug selection C1” (24.2%; 185/763), “dose selection C3” (21.5%; 164/763) and “treatment duration C4” (17.7%; 135/763). Antibiotics, corticosteroids, and proton pump inhibitors were the three primary medication classes associated with DRPs. Patients, hospitalized for more than eight days, taking ten or more drugs or having renal dysfunctions were more likely to have drug-related problems. Pharmacists totally proposed 1557 interventions to address the problems. Most interventions (91.0%; 1418/1557) were accepted, and 91.6% of the problems were solved. Conclusion The prevalence of drug-related problems among the studied COPD patients was high. Pharmacists can have an important role in addressing the problems and optimizing the safety and effectiveness of therapies for hospitalized COPD patients.

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Role of volar plating in unstable distal radial fractures in elderly patients in tertiary teaching hospital

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20210627 ◽

2021 ◽

Vol 7 (2) ◽

pp. 339

Author(s):

Santhosh Kumar S. ◽

Amarnath Surat ◽

Rami Reddy M. ◽

K. Satya Kumar

Keyword(s):

Elderly Patients ◽

Distal Radius ◽

Plate Fixation ◽

The Elderly ◽

Dash Score ◽

Distal Radial Fractures ◽

Extensor Pollicis Longus ◽

Medical College ◽

Tertiary Teaching ◽

Tertiary Teaching Hospital

Background: Aim of the study was to investigate the efficacy of volar locking plate fixation for unstable distal radical fractures DRFs in the elderly population (60 years old and older).Methods: An ethical committee approved the study protocol for research studies at NRI medical college. We included only unstable distal radial fractures in elderly patients between 60 to 70 years, and patients who consent to the study. We excluded patients with comorbid conditions and below 60 years and patients with vascular injuries. Results were evaluated by the DASH questionnaire and Gartland and Werley scores.Results: According to Gartland and Werley score, 30 patients (85.7%) had excellent and good results. According to the DASH score, 31 patients (88.5%) had excellent and good results, and four patients (11.4%) had fair results. The most commonly noted complications in our study were arthritis (2 cases 5.7%), extensor pollicis longus tendon irritation (1 case 2.9%), and Reflex sympathetic dystrophy (1 case 2.9 %).Conclusions: Locked compression plate in unstable distal radius fractures provides excellent results with an effective correction of distal radius anatomy. Early range of movements of joints leads to a good outcome and return to regular activity.

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Analysis of prognosis in hospitalized elderly patients with pneumonia according to age groups

Türkiye Aile Hekimliği Dergisi ◽

10.15511/tahd.17.00317 ◽

2017 ◽

Vol 21 (3) ◽

pp. 109-117

Author(s):

Ayşegül Albay ◽

Bengü Şaylan ◽

Hacer Sali Çakır ◽

Sema Basat

Keyword(s):

Elderly Patients ◽

Age Groups ◽

Hospitalized Elderly ◽

Hospitalized Elderly Patients

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Factors Impacting CTCA Quality in a Major Tertiary Teaching Hospital

Heart Lung and Circulation ◽

10.1016/j.hlc.2021.06.212 ◽

2021 ◽

Vol 30 ◽

pp. S189

Author(s):

I. Button ◽

J. Bradley ◽

R. Roberts-Thomson ◽

B. Lorraine

Keyword(s):

Teaching Hospital ◽

Tertiary Teaching ◽

Tertiary Teaching Hospital

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Using Technology to Promote Patient Engagement in Nutrition Care: A Feasibility Study

Nutrients ◽

10.3390/nu13020314 ◽

2021 ◽

Vol 13 (2) ◽

pp. 314

Author(s):

Shelley Roberts ◽

Wendy Chaboyer ◽

Zane Hopper ◽

Andrea P. Marshall

Keyword(s):

Patient Satisfaction ◽

Patient Engagement ◽

Early Discharge ◽

Nutritional Risk ◽

Dietary Intakes ◽

Intervention Delivery ◽

Nutrition Care ◽

Tertiary Teaching ◽

Hospital Patients ◽

Tertiary Teaching Hospital

Empowering patients to participate in nutrition care during hospitalisation may improve their dietary intakes and associated outcomes. This study tested the acceptability and feasibility of a technology-based intervention to engage hospital patients in nutrition care at a tertiary teaching hospital in Australia. The hospital used an electronic foodservice system (EFS), by which patients ordered meals via bedside computers. Adults at nutritional risk received the nutrition technology (NUTRI-TEC) intervention, involving nutrition assessment, education on nutrition requirements and training on using the EFS to enter food intakes and monitor nutrition goals. Acceptability was assessed using patient satisfaction and engagement surveys. Feasibility was assessed by evaluating the intervention delivery/fidelity and patient recruitment/retention. Patients’ dietary intakes were observed daily to indicate the intervention’s effects and assess the accuracy of the patient-recorded intakes. Descriptive and inferential statistics were used to analyse the data. Of the 71 patients recruited, 49 completed the study (55% male; median (IQR) age 71 (65–78) years; length of stay 10 (7–14) days). Patient satisfaction with NUTRI-TEC was high. Intervention delivery and fidelity targets were met but recruitment (≥50%) and retention (≥75%) targets were not; only 31% of patients agreed to participate and 69% completed the study (mostly due to unexpected/early discharge). Patient- and researcher-recorded dietary intakes correlated strongly, indicating patients can record food intakes accurately using technology. This study highlights the important role technology is likely to play in facilitating patient engagement and improving care during hospitalisation.

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