Risk factors for drug therapy problems among Cambodian Americans with complex needs: a cross-sectional, observational study

Abstract

Background Pharmaceutical drug therapy problems (DTPs) are a major public health problem. We examined patient-level risk factors for DTPs among Cambodian Americans. Methods Community health workers (CHWs) verbally administered surveys and completed a detailed medication review form with participants. A doctoral-level pharmacist reviewed the form with the patient and CHW to determine DTP number and type (appropriateness, effectiveness, safety, and adherence). Results Participants ( n = 63) averaged 55 years old, 6 years of education, 52% were married, 87% spoke Khmer at home, with modal household income <$20,000 (41%). The percentage of participants with DTPs was: 45% appropriateness, 25% effectiveness, 64% safety, and 30% adherence, averaging 3.7 DTPs per patient. In multiple regressions, patient characteristics uniquely predicted each type of DTP. In a multiple regression controlling for number of medications, being married reduced total DTPs (IRR = 0.70) and being depressed increased total DTPs (IRR = 1.26). Conclusions Vulnerable patients should be prioritized for pharmacist/CHW teams to identify DTPs. Trial registration:

Community-based diabetes prevention randomized controlled trial in refugees with depression: effects on metabolic outcomes and depression

“…For many Cambodian Americans the depression becomes chronic, with pre-migration trauma increasing odds of major depressive disorder even decades after resettlement (odds ratio = 1.56) 11 . Cambodian Americans may receive medication for their health needs, but barriers related to language, finances, and very low educational attainment may create drug therapy problems with polypharmacy, drug safety, appropriateness, effectiveness, and adherence 12 . Medication therapy management (MTM) is a pharmacist intervention designed to resolve drug therapy problems 13 ; MTM is not designed to test any particular medication.…”