Duplicate prescriptions—proposal of a clinically oriented categorisation

Heck, Johannes; Krichevsky, Benjamin; Stichtenoth, Dirk O.; Siederdissen, Christoph Höner zu

doi:10.1007/s00228-021-03143-8

Cited by 5 publications

(25 citation statements)

References 9 publications

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“…study regarding the frequency and characteristics of medication classes involved in duplicate prescriptions can be explained by different methodological approaches (our study: PIDP definition according to Heck et al. ; 16 Eshetie et al. study: Screening Tool of Older Person's Prescriptions criteria 33 ) as well as by different study populations (our study: psychiatric inpatients ≥60 years in Germany; Eshetie et al.…”

Section: Discussionmentioning

confidence: 93%

“…Potentially inappropriate duplicate prescriptions (PIDPs) were analyzed according to the recently proposed categorization by Heck et al 16 . Overall, 29 PIDPs were detected in the study cohort; PIDP grade 1—defined as the prescription of “two drugs with overlapping or comparable pharmacodynamics” 16 —accounted for 62.1%, grade 2—defined as the prescription of “two drugs of the same therapeutic class (that is, targeting the same molecular structure)” 16 —accounted for 20.7%, and grade 3—defined as the prescription of “two times the same drug (exceeding the recommended maximum daily dose)” 16 —accounted for 17.2% of all PIDPs. All grades combined, psychopharmaceuticals were most frequently involved in PIDPs (34.5%; 10/29), followed by analgesics (24.1%; 7/29) and antihypertensives (17.2%; 5/29) (Figure 2C).…”

Section: Resultsmentioning

confidence: 99%

“…potentially inappropriate medications for the elderly (according to the PRISCUS list 15 ; n = 59) (B), and potentially inappropriate duplicate prescriptions (according to Heck et al 16 ; n = 29) (C) discrepancies reflect country-specific characteristics in terms of drug availability and prescribing preferences, limiting comparability between studies.…”

Section: Discussionmentioning

confidence: 99%

“…In summary, MRPs in the present study were defined as clinically relevant drug–drug and drug–disease interactions, PIMs (according to the PRISCUS list 15 ), potentially inappropriate duplicate prescriptions (according to Heck et al 16 …”

Section: Methodsmentioning

confidence: 99%

“…The adjusted coefficient of determination R 2 adj was calculated as 0.747, suggesting a strong linear relationship between the number of drugs prescribed and the number of MRPs. 17 According to Heck et al 16 HECK ET AL.…”

Section: Relationship Between the Number Of Drugs Prescribed And The ...mentioning

confidence: 99%

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Medication‐related problems in geriatric psychiatry—a retrospective cohort study

Heck

Ihlefeld

Krause

et al. 2022

Int J Geriat Psychiatry

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Objectives: Information on medication-related problems (MRPs) in elderly psychiatric patients is scarce. In the present study, we analyzed the frequency and characteristics of MRPs in patients ≥60 years treated on the gerontopsychiatric ward of Hannover Medical School in 2019. Methods: Taking advantage of an interdisciplinary approach, two independent investigators screened hospital discharge letters of 230 psychiatric inpatients for clinically relevant MRPs, followed by validation through an interdisciplinary expert panel. Drug interactions as a subset of MRPs were analyzed with the aid of two different drug interaction programs. Results: 230 patients (63.0% female, mean age 73.7 � 8.4 years, median length of stay 18 days) were prescribed a median of 6 drugs. In total, 2180 MRPs were detected in the study population and 94.3% of the patients exhibited at least one MRP. Patients displayed a median of 7 MRPs (interquartile range 3-15). Pharmacodynamic interactions accounted for almost half of all MRPs (48.1%; 1048/2180).The number of drugs prescribed and the number of MRPs per patient showed a strong linear relationship (adjusted R 2 = 0.747). Conclusion:An exceedingly high proportion of elderly psychiatric inpatients displayed clinically relevant MRPs in the present study, which may be explained by the multimorbidity prevalent in the study population and the associated polypharmacy.The number of drug interactions was largely in accordance with previous studies. As a novel finding, we detected that a considerable proportion of elderly psychiatric inpatients were affected by potential prescribing omissions, potentially inappropriate duplicate prescriptions, and insufficient documentation.

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Section: Discussionmentioning

confidence: 93%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Relationship Between the Number Of Drugs Prescribed And The ...mentioning

confidence: 99%

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Medication‐related problems in geriatric psychiatry—a retrospective cohort study

Heck

Ihlefeld

Krause

et al. 2022

Int J Geriat Psychiatry

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Duplicate prescriptions in the emergency department: a retrospective cohort study

Heck

Krichevsky

Groh

et al. 2022

Eur J Clin Pharmacol

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Purpose To determine the nature and frequency of duplicate prescriptions (DPs) in the emergency department (ED) by utilization of a novel categorization of DPs which differentiates between appropriate DPs (ADPs) and potentially inappropriate DPs (PIDPs). Methods In this retrospective cohort study, adult patients who presented to the ED for internal medicine of a large university hospital in northern Germany in 2018 and 2019 were screened for the presence of DPs. Descriptive statistical methods were used to characterize the nature and frequency of PIDPs compared to the frequency of ADPs. Results A total of 4208 patients were enrolled into the study. The median age of the study population was 63 years (interquartile range (IQR) 48–77), 53.9% were female. The patients took a median of 5 drugs (IQR 3–9). 10.9% of the study population were affected by at least one PIDP (at least one grade-1 PIDP: 6.1%; at least one grade-2 PIDP: 4.5%; at least one grade-3 PIDP: 1.1%). Non-opioid analgesics accounted for the majority of grade-1 PIDPs, while inhalatives were most frequently responsible for grade-2 and grade-3 PIDPs. Nearly half of the study population (48.6%) displayed at least one ADP. Conclusion PIDPs pose a frequent pharmacological challenge in the ED. The medication review should comprise a systematic screening for PIDPs with a particular focus on non-opioid analgesics and inhalatives. ADPs were detected more frequently than PIDPs, questioning the predominant notion in the medical literature that DPs are exclusively deleterious.

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Development and validation of a clinical decision support system to prevent anticoagulant duplications

Dahmke,

Cabrera-Diaz,

Heizmann

et al. 2024

International Journal of Medical Informatics

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Duplicate prescriptions—proposal of a clinically oriented categorisation

Cited by 5 publications

References 9 publications

Medication‐related problems in geriatric psychiatry—a retrospective cohort study

Medication‐related problems in geriatric psychiatry—a retrospective cohort study

Duplicate prescriptions in the emergency department: a retrospective cohort study

Development and validation of a clinical decision support system to prevent anticoagulant duplications

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