scholarly journals Drug related problems in admitted geriatric patients: The impact of clinical pharmacist interventions

2019 ◽  
Author(s):  
Berhane Yohannes Hailu ◽  
Derbew Fikadu Berhe ◽  
Esayas Kebede Gudina ◽  
Kidu Gidey ◽  
Mestwat Getachew
Keyword(s):  
Clinical Pharmacist ◽  
Geriatric Patients ◽  
Medical Center ◽  
Optimization Methods ◽  
Acceptance Rate ◽  
Drug Related Problems ◽  
Treatment Optimization ◽  
Pharmacist Interventions ◽  
Age Related ◽  
The Impact

Abstract Background: Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients are often excluded from premarketing trials that can further increase the occurrence of DRPs. This study was aimed to identify DRPs and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization. Methods: A prospective observational study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems. Results: A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR]=4.350, 95% C.I: 1.212-9.260, p = 0.020) and number of comorbidities (AOR=1.588, 95% C.I: 1.029-2.450, p = 0.037). Conclusions: Drug related problems were substantially high among geriatric inpatients. Geriatric patients with polypharmacy and comorbidities need special attention to prevent drug related problems. Involving clinical pharmacist in the clinical team resulted in the improved acceptance rate of treatment optimization.

scholarly journals Drug related problems in admitted geriatric patients: The impact of clinical pharmacist interventions

2019 ◽  
Author(s):  
Berhane Yohannes Hailu ◽  
Derbew Fikadu Berhe ◽  
Esayas Kebede Gudina ◽  
Kidu Gidey ◽  
Mestwat Getachew
Keyword(s):  
Clinical Pharmacist ◽  
Geriatric Patients ◽  
Medical Center ◽  
Acceptance Rate ◽  
Drug Related Problems ◽  
Treatment Optimization ◽  
Pharmacist Interventions ◽  
Age Related ◽  
The Impact ◽  
Geriatric Inpatients

Abstract Background : Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients are often excluded from premarketing trials that can further increase the occurrence of DRPs. This study was aimed to identify DRPs and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization.Methods : A prospective observational study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems.Results: A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR]=4.350, 95% C.I: 1.212-9.260, p = 0.020) and number of comorbidities (AOR=1.588, 95% C.I: 1.029-2.450, p = 0.037).Conclusions : Drug related problems were substantially high among geriatric inpatients. Geriatric patients with polypharmacy and comorbidities need special attention to prevent drug related problems. Involving clinical pharmacist in the clinical team resulted in the improved acceptance rate of treatment optimization.

scholarly journals Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Berhane Yohannes Hailu ◽  
Derebew Fikadu Berhe ◽  
Esayas Kebede Gudina ◽  
Kidu Gidey ◽  
Mestawet Getachew
Keyword(s):  
Clinical Pharmacist ◽  
Geriatric Patients ◽  
Drug Related Problems ◽  
Pharmacist Interventions ◽  
The Impact

scholarly journals Positive evidence for clinical pharmacist interventions during interdisciplinary rounding at a psychiatric hospital

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Matej Stuhec ◽  
Valentina Tement
Keyword(s):  
Psychiatric Hospital ◽  
Clinical Pharmacist ◽  
Psychiatric Hospitals ◽  
Acceptance Rate ◽  
Potential Drug ◽  
The European Union ◽  
Drug Related Problems ◽  
Ward Rounds ◽  
The Impact ◽  
Very High

AbstractClinical pharmacists have not yet become an integral part of interdisciplinary ward rounds in most psychiatric hospitals across the European Union. This retrospective observational pre-post study examined the impact of clinical pharmacist recommendations in an interdisciplinary medical team during psychiatric hospital rounding. The study included all patients in a Slovenian psychiatric hospital who were hospitalized 2019–2020. The clinical pharmacist made 315 recommendations for a total of 224 participants (average age M = 59.4, median = 56). Psychiatrists accepted 295 (93.7%) of the recommendations. After the recommendations, the number of expressed and potential drug-related problems decreased in 166 (93.8%) and 129 (93.8%) interventions, respectively. Three months after discharge, 222 accepted recommendations were continued (70.5%). The most common recommendations were related to antipsychotics (19.4%, N = 61) followed by antidepressants (16.8%, N = 53). Including a clinical pharmacist in the interdisciplinary ward rounds at a psychiatric hospital reduced the number of expressed and potential drug-related problems with a very high recommendation acceptance rate. These results are the first in Central Europe to explore the benefits of including a clinical pharmacist in ward rounding.

scholarly journals Assessment of drug related problems and clinical pharmacist interventions in paediatric department of a tertiary care teaching hospital

2018 ◽  
Vol 7 (10) ◽  
pp. 1934 ◽  
Author(s):  
Deepishka Pemmasani ◽  
Sai Deepak Gali ◽  
Maanasa Arcot ◽  
Durga Prasad T. S.
Keyword(s):  
Clinical Pharmacist ◽  
Tertiary Care ◽  
Acceptance Rate ◽  
Pediatric Care ◽  
Drug Related Problems ◽  
Interventional Study ◽  
Pediatric Department ◽  
Major Significance ◽  
Pharmacist Interventions ◽  
Paediatric Department

Background: Drug-related problems (DRPs) are frequent in hospitalization in pediatrics. The main aim of present investigation is to assess drug related problems and clinical pharmacist interventions in pediatric department of tertiary care hospital.Methods: It was a prospective, observational and interventional study carried over a period of 6 months.Results: A total of 66 patients were identified with drug related problems. Among them 31 (42%) were in between 1month–2 years followed by 25 (34%) were in between 2-11 years, 10(24%) were in between 11-18 years of age. 30(45.3%) patients were prescribed with 0-3 drugs followed by 21 (31.3%) were prescribed with 3-5 drugs, 15(23.3%) were prescribed with 6-10 drugs. Most of the DRP’s observed in the study were drug interactions 52(78.78%) [major-19 (36.53%), moderate-27 (5192%) and minor-6(11.53%)] followed by adverse drug reactions 12 (18.18%), and duplication errors were 2 (3.03%). Majority of the clinical pharmacist recommendations were duration change 52 (34.66%), drug change 10(6.66%), dose reduction 2 (1.35%) followed by drug termination 2 (1.33%). Major significance of DRPs were noted high 31(57.96%), whereas 25 (39.8%) were moderate and 8 (12.12%) were minor. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high in 57 (86.66%) cases while in 9 (13.33%) cases suggestions were accepted but therapy was not changed. There were no cases with neither suggestion were accepted nor therapy changed.Conclusions: Clinical pharmacist involvement in inpatient pediatric care can significantly help to identify, resolve and prevent the drug related problems. The study concluded that the clinical pharmacist has a significant role in patients care at hospital.

Drug-related problems with targeted/immunotherapies at an oncology outpatient clinic

2019 ◽  
Vol 26 (3) ◽  
pp. 595-602
Author(s):  
Esra Kucuk ◽  
Aygin Bayraktar-Ekincioglu ◽  
Mustafa Erman ◽  
Saadettin Kilickap
Keyword(s):  
Adverse Drug Event ◽  
Clinical Pharmacist ◽  
Adverse Drug Events ◽  
Drug Event ◽  
Targeted Chemotherapy ◽  
Drug Related Problems ◽  
Patients With Cancer ◽  
Common Drug ◽  
Oncology Care ◽  
The Impact

Background Some studies in the literature describe drug-related problems in patients with cancer, although few studies focused on patients receiving targeted chemotherapy and/or immunotherapy. To identify the incidence of drug-related problems in patients receiving targeted chemotherapy and/or immunotherapy, and demonstrate the impact of a clinical pharmacist in an outpatient oncology care setting. Methods Prospective study was conducted in a hospital outpatient oncology clinic between October 2015 and March 2016. Patients greater than 18 years old receiving cetuximab, nivolumab, ipilimumab, or pembrolizumab were included in the study and monitored over a three-month period by a clinical pharmacist. Drug-related problems were analyzed using the Pharmaceutical Care Network Europe classification system. The main outcome measures were the frequency and causes of drug-related problems and the degree of resolution achieved through the involvement of a clinical pharmacist. Results A total of 54 patients (mean age: 57 ± 12 years) were included. There were 105 drug-related problems and 159 associated causes. Among the planned interventions (n = 149), 92 interventions were at the patient-level with 88 (96%) being accepted by the doctors. This resulted in 68 (65%) drug-related problems being completely resolved and 9 (8.6%) being partially resolved. The most common drug-related problem identified was “adverse drug event” (n = 38, 36%). Of the 105 drug-related problems, 63 (60%) related to targeted chemotherapy and/or immunotherapy with 34 (54%) classified as an “adverse drug event.” Conclusion Adverse drug events were the most common drug-related problems in patients with cancer. The involvement of a clinical pharmacist improved the identification of drug-related problems and helped optimize treatment outcomes in patients receiving targeted chemotherapy/immunotherapy.

Drug-related problems identification in general internal medicine: The impact and role of the clinical pharmacist and pharmacologist

2015 ◽  
Vol 26 (6) ◽  
pp. 399-406 ◽  
Author(s):  
Bertrand Guignard ◽  
Pascal Bonnabry ◽  
Arnaud Perrier ◽  
Pierre Dayer ◽  
Jules Desmeules ◽  
...  
Keyword(s):  
Internal Medicine ◽  
General Internal Medicine ◽  
Clinical Pharmacist ◽  
Drug Related Problems ◽  
General Internal ◽  
The Impact

Prescribers' perceptions on the impact of hydrocodone rescheduling on geriatric pain management: A qualitative study

2018 ◽  
Vol 14 (5) ◽  
pp. 317-326
Author(s):  
Julianna Fernandez, PharmD, BCPS, CGP ◽  
James Douglas Thornton, PhD, PharmD, BCPS ◽  
Sanika Rege, MS ◽  
Benjamin Lewing, MS ◽  
Shweta Bapat, BPharm ◽  
...  
Keyword(s):  
Pain Management ◽  
Focus Groups ◽  
Geriatric Patients ◽  
Medical Center ◽  
Academic Medical Center ◽  
Monitoring Program ◽  
Prescribing Patterns ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Objective: To qualitatively assess prescribers’ perceptions regarding the consequences associated with hydrocodone rescheduling among geriatric patients being discharged from inpatient settings.Design: This was a cross-sectional study.Setting: Two focus groups were conducted by a trained facilitator in a metropolitan academic medical center in January 2016.Participants: Prescribers who manage noncancer pain for geriatric patients were recruited. Focus groups were recorded, transcribed, and then analyzed using ATLAS.ti Qualitative Data Analysis software. Codes were derived from six primary research questions and results were summarized into key themes regarding the impact of rescheduling.Main outcome measures: Prescribers’ perceptions regarding hydrocodone rescheduling.Results: Prescribers mentioned that they review the prescription monitoring program (PMP) more often before prescribing opioids after rescheduling. They expressed concern regarding the required special serialized prescription forms needed to issue schedule II prescriptions. This led to substituting hydrocodone with potentially less effective pain medications, the inability to issue refills on hydrocodone prescriptions, and an ethical concern over prescribing hydrocodone to patients not under their direct care. Additionally, rescheduling has affected the coordination of care upon discharge, as patients moving to long-term care or skilled nursing facilities may not have adequate pain management when transferred.Conclusions: The majority of physicians felt rescheduling negatively impacted both practical and ethical aspects of patient care related to pain management after discharge. Rescheduling has changed physicians’ hydrocodone prescribing patterns, leading to more caution when prescribing hydrocodone and greater use of the PMP. Future studies should assess geriatric patients’ satisfaction and quality of life regarding pain management since hydrocodone was rescheduled.

scholarly journals Age Attenuates Testosterone Secretion Driven by Amplitude-Varying Pulses of Recombinant Human Luteinizing Hormone during Acute Gonadotrope Inhibition in Healthy Men

2007 ◽  
Vol 92 (9) ◽  
pp. 3626-3632 ◽  
Author(s):  
Paul Y. Takahashi ◽  
Patrick Votruba ◽  
Mohammed Abu-Rub ◽  
Kristi Mielke ◽  
Johannes D. Veldhuis
Keyword(s):  
Half Life ◽  
Medical Center ◽  
Academic Medical Center ◽  
Community Dwelling ◽  
Controlled Study ◽  
Deconvolution Analysis ◽  
Healthy Men ◽  
Age Related ◽  
Aging Men ◽  
The Impact

Abstract Context: Whether testosterone (Te) depletion in aging men reflects deficits in the testis, hypothalamus, and/or pituitary gland is unknown. Objective: Our objective was to quantify the impact of age on gonadal Te secretion driven by amplitude-varying pulses of recombinant human LH (rhLH) in the absence of confounding by endogenous hypothalamo-pituitary signals. Design: This was a double-blind, placebo-controlled study. Setting: The setting was an academic medical center. Subjects: Fifteen healthy community-dwelling men ages 22–78 yr were included in the study. Intervention: Saline or four separate rhLH doses were each infused twice iv in randomized order as one pulse every 2 h over 20 h to stimulate Te secretion, after LH secretion was suppressed by a GnRH-receptor antagonist, ganirelix. Main Outcome: LH and Te concentrations were determined in blood samples collected every 5 min. Maximal and minimal (as well as mean) Te responses were regressed linearly on age to reflect LH peak and nadir (and average) effects, respectively. Results: The ganirelix/rhLH paradigm yielded serum LH concentrations of 4.6 ± 0.22 IU/liter (normal range 1–9). By regression analysis, age was associated with declines in rhLH pulse-stimulated peak and nadir (and mean) concentrations of total Te (P = 0.0068), bioavailable Te (P = 0.0096), and free Te (P = 0.013), as well as lower Te/LH concentration ratios (P < 0.005). Deconvolution analysis suggested that the half-life of infused LH increases by 12%/decade (P = 0.044; R2 = 0.28). Conclusions: Infusion of amplitude-varying pulses of rhLH during gonadal-axis suppression in healthy men unmasks prominent age-related deficits in stimulated total (39%), bioavailable (66%), and free (63%) Te concentrations, and a smaller age-associated increase in LH half-life. These data suggest that age-associated factors reduce the efficacy of LH pulses.

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