Impact of Clinical Pharmacist-Led Geriatric Patients Medication Chart Review in Tertiary Care Teaching Hospital: An Interventional Study

OBJECTIVES:

Geriatric patients suffering from chronic diseases experience polypharmacy leading to many drug-related problems (DRPs). The study aimed to identify and resolve drug-related issues among elderly patients using PCNE classification and to evaluate the potentially inappropriate medication (PIM) among elderly patients.

METHODS:

An interventional study was conducted for eight months (December 2021-July 2022) on geriatric patients of either sex who were admitted to the Department of General Medicine at a tertiary care teaching hospital suffering from chronic diseases. The clinical pharmacist reviewed the patient's medication chart to identify drug-related problems and evaluated potentially inappropriate medications using STOPP criteria. Intervention includes the identified DRPs communicating with the physicians to resolve. The Institutional ethics committee approved the study (Ref.no. KLE/COP/2021-22/674). Written informed consent was taken before enrolling the patient in the study.

RESULTS:

A total of 122 patients were included in the study, 61 in each intervention and control group. Using PCNE classification, 163 drug-related problems were identified in 122 patients, of which 86 (52.76%) were found in the control group and 77 (47.24%) in the intervention group. 'Treatment effectiveness' (54%) was both groups' most common domain problem. The most common cause of these drug-related problems was 'Drug selection' and 'Patients related.', A total of 78 interventions were proposed (most at the prescriber level with 30.8%), of which 52 (66%) were accepted the by the physician and implemented to resolve identified drug-related problems. A total of 52 potentially inappropriate medications were identified using STOPP criteria, and the most common ones were 'Duplicate drug class' (13.4%). Control group DRPs were resolved before the patient was discharged from the hospital and were not documented.

CONCLUSIONS:

66% of the DRPs were resolved in the intervention group, which can be preventable by the intervention of a pharmacist, thereby reducing drug-related problems and potentially inappropriate medications.