Impact of Polypharmacy, Drug-Related Problems, and Potentially Inappropriate Medications in Geriatric Patients and Its Implications for Bulgaria—Narrative Review and Meta-Analysis

Krustev, Tzvetan; Milushewa, Petya; Tachkov, Konstantin

doi:10.3389/fpubh.2022.743138

Cited by 17 publications

(13 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous study performed a meta-analysis of the reported risks for PIPs and related risk for Bulgaria ( 34 ). It calculated that 244,227 people are exposed to risk for PIP in the population above 65 years of age.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of potentially inappropriate medication in older patients with cardiovascular diseases—STOPP/START-based study

Krustev

Milushewa

Tachkov

et al. 2022

Front. Public Health

Self Cite

View full text Add to dashboard Cite

ObjectiveThis study aims to evaluate the use of STOPP/START criteria in the identification of Potentially inappropriate medication and potential prescribing omissions in older patients with cardiovascular diseases in Bulgaria. Excessive morbidity and mortality has been linked to drug-related problems and increased use of healthcare services and is an understudied problem for Bulgaria.Materials and methodsA prospective, questionnaire-based study was conducted among 543 older patients across 25 pharmacies in Bulgaria. Socio-demographic characteristic, disease profile, symptoms, and medication data were collected. The questionnaire was developed for the purposes of the EUROAGEISM project. Out of all 543 patients, only those with documented cardio-vascular diseases were extracted and the medication profile per patient was evaluated for Potentially inappropriate medication (PIMs) and potentially prescribing omissions (PPOs) using STOPP/START criteria version 2. In addition, several risks for potentially inappropriate prescribing (PIPs), PPOs and PIMs were calculated with the focus being on the Odds and Risks to develop a PIP.ResultsFour hundred and twenty eight from 531 patients with known therapy for cardiovascular diseases (CVDs) were included in the analysis of PIP (40.52% aged 65–69 years, 61.88% female, 64% had up to 6 comorbidities, and 21.72% presenting with polypharmacy). A total of 71 PIMs in 64 patients with polypharmacy were identified during applying STOPP criteria. 56% of patients taking above five medicines daily had PIMs. The majority of PIMs (31%) were related to CVDs treatment, followed by PIMs in the treatment of endocrine diseases (22.54%), duplication of medicines (8.46%) and prolonged treatment with benzodiazepines (8.46%). Forty four PPOs were identified with START criteria. 22.72% were related to lack of proton pump inhibitors (PPI) in the presence of gastroesophageal disorders, and the same percentage was for lack of Calcium-vitamin D supplementation in osteoporosis. Applying the methodology of risks calculation the sample risk for PPO was 2.1% and for PIM 3.4%. At sample level the relative risk for PPO was 62% out of the risk for PIM and at population level varied between 42.8 and 89.8% and it is statistically significant. The number needed to treat for the event to happen is 77.5, meaning that at every 78 prescriptions there is a chance to appear PIP.ConclusionApplication of methodologies for detection of potentially inappropriate prescribing is not part of routine clinical practice in Bulgaria. Our study demonstrates a high percentage of potentially inappropriate medication among older patients with polypharmacy. Along with the aging population in Bulgaria, economic burden of polypharmacy and the prevalence of cardiovascular diseases, it is especially important to address potentially inappropriate medication use in cardiovascular patients. There is a considerable necessity for implementation of measures for early detection of potentially inappropriate medication and potentially prescribing omission as a part of de-prescribing strategies in older patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of potentially inappropriate medication in older patients with cardiovascular diseases—STOPP/START-based study

Krustev

Milushewa

Tachkov

et al. 2022

Front. Public Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…(16 patients). In geriatrics, polypharmacy can lead to DRPs [4], hospitalization and nonadherence to medications [15].…”

Section: Patient Characteristicsmentioning

confidence: 99%

“…The most prevalent form of diabetes in older people is type 2 diabetes mellitus (T2DM). The geriatric population is susceptible to many co-morbidities and complications of DM that can affect morbidity and mortality [3] making it possible to experience polypharmacy associated with drug-related problems (DRPs) [4]. Medicine interactions, polypharmacy, and incorrect drug prescriptions in the elderly can all have a negative impact on their quality of life, necessitating extra care [5].…”

Section: Introductionmentioning

confidence: 99%

Drug-related problems in elderly patients with diabetes: A study in primary health care setting

Cahyaningsih¹,

Maziyyah²

2023

J Adv Pharm Educ Res

View full text Add to dashboard Cite

show abstract

“…In Egypt, there is an increasing incidence of cancer (6) . Polypharmacy is a major issue for cancer patients, especially in the elderly and it is a key risk of occurrence of DRPs (7) . Cancer treatment is complex and could result in many DRPs such as adverse reactions, medication errors, DDIs, and nonadherence which may cause drug-related morbidity and mortality (8) , that's why detecting and resolving them is critical to achieving the optimum therapeutic outcomes and minimize cost spent for emergency department visits, hospital admissions and additional visits that could be needed as a result of DRPs (9) .…”

Section: Introductionmentioning

confidence: 99%

“…It has been demonstrated that including hospital pharmacists in multidisciplinary teams improves the detection and resolution of DRPs (11) . There is a need for clinical pharmacist intervention that could minimize DRPs and improve QoL (6,7) .…”

Section: Introductionmentioning

confidence: 99%

A Pharmaceutical Care Plan to Minimize the Incidence of Potential Drug-Related Problems in Cancer Patients

Nabil¹,

El-Shitany²,

Shawki³

et al. 2022

The Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Background: Drug-related problems (DRPs) are frequent among cancer patients and can have a poor influence on the quality of life (QoL), and increase morbidity as well as mortality. Aim of the work:This study aimed to assess the impact of clinical pharmacist-implemented prescriber's education on the prevalence of DRPs and patients' QoL. Patients and Methods: A cross-sectional, 3 phases interventional study (pre-education phase, education phase, and posteducation phase) was conducted between May 2018 and May 2020. Prescriptions and filled QoL questionnaires were collected for 500 patients in pre-education and 500 patients' post-education phases from Cairo University National Cancer Institute (Cairo, Egypt) and Assiut University Hospital (Assiut, Egypt). The QoL for each patient was assessed using the Arabic version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 QoL questionnaire. Results: Following clinical pharmacist education, the total number of DRPs in the post-education phase significantly decreased by 43.14 % (p<0.0001) compared to the pre-education phase. The acceptance rate of prescribers was 88.6% to the recommendations done by the clinical pharmacist. Comparing EORTC QLQ C30 questionnaire scores in pre-and posteducation phases, there was a statistically significant improvement with fewer problematic patients in the global health status, functional, and symptom scales in the post-education phase. Conclusion: Pharmacist interventions can potentially minimize the incidence of DRPs and are associated with improvement of QoL scores which highlights the importance of the clinical pharmacist's role in cancer care.

show abstract

Impact of Polypharmacy, Drug-Related Problems, and Potentially Inappropriate Medications in Geriatric Patients and Its Implications for Bulgaria—Narrative Review and Meta-Analysis

Cited by 17 publications

References 29 publications

Evaluation of potentially inappropriate medication in older patients with cardiovascular diseases—STOPP/START-based study

Evaluation of potentially inappropriate medication in older patients with cardiovascular diseases—STOPP/START-based study

Drug-related problems in elderly patients with diabetes: A study in primary health care setting

A Pharmaceutical Care Plan to Minimize the Incidence of Potential Drug-Related Problems in Cancer Patients

Contact Info

Product

Resources

About