OBJECTIVES :
- Identifying and classifying drug related problems (DRPs) among elderly autoimmune disorder patients
- To provide clinical pharmacist interventions to resolve DRPs in elderly autoimmune disorder patients
- To identify the predictors of DRPs in elderly autoimmune disorder patients
METHODS : A cross-sectional study was conducted at the Department of Rheumatology in an 1800 bedded tertiary care teaching hospital over a period of 18 months among elderly autoimmune disorder patients. A pharmacist-led multidisciplinary team was formed to evaluation and implementing clinical pharmacist interventions to resolve DRPs. PCNE v8.02 was used to classify the DRPs. Clinical pharmacist interventions were rated base on by Dooley et al (2003). Descriptive statics applied for continuous variables and multiple logistic regression (95% Cl, P<0.005) applied to evaluate predictors of DRPs.
RESULTS : A total of 148 elderly (≥60 years) patients were enrolled in this study. The mean age was 66.42±4.23 years, with 92.14% female. Majority of patients (72.89%) were received ≥ 5 drugs and 62.4% having ≥3 comorbidities. A total of 1689 drugs, an average of 9.22±4.72 drug prescribed per patient. A total of 217 DRPs identified among study patient, an average of 1.47±4.72 DRP per patient, mostly related to treatment safety (46.24%). Overall, 249 causes of DRPs were identified, of which 22.16% related to the “patient”. Clinical pharmacist recommended intervention for the identified DRPs, majority were at “drug level” (41.92%) followed by “patient level” (36.22%),], the majority recommended interventions were related to moderate significance. Among proposed intervention, 96.34% were accepted leads to resolution of 94.42% DRPs. The major predictor included age between 70-80 years, polypharmacy (>5 drugs), diabetes and methotrexate with odd ratio 6.42[2.80-16.24], 4.11 [1.06-14.4], 8.34 [2.21-32.24] and 4.44 [0.21-15.32] respectively.
CONCLUSIONS Providing clinical pharmacist care to elderly autoimmune disorder patients helps to prevent and solve drug related problems, which ensure therapeutic safety and reduce economic burden.
