Identification of potential drug-related problems in the elderly: the role of the community pharmacist.
OBJECTIVE
The high prevalence of multiple drug use combined with age-related changes in pharmacokinetics and pharmacodynamics makes older adults more vulnerable to drug-related problems (DRPs). This pharmacy-based study was performed to identify potential DRPs from prescription records of the elderly and the role of the pharmacist in this process.


METHODS
The study was performed from June 2002 to February 2003 in 16 community pharmacies in the Netherlands. Medication assessment of elderly patients aged 65 and over using six or more drugs concomitantly took place on the date of inclusion. Ten types of potential DRPs, grouped into three categories, were determined. The three groups were patient-related, prescriber-related or drug-related potential DRPs. We looked at the occurrence, nature and determinants of differential potential DRPs.


RESULTS
The mean number of prescriptions per patient was 8.7. In total 3.9 potential DRPs per elderly person were identified. The distribution of the potential DRPs over the three categories was: patient related 4.7%, prescriber related 55.7% and drug related 39.6%. Use of NSAIDs (OR 29.9; 95% CI 4.1-219) and digoxin (OR 15.7; 95% CI 4.9-50.5) were associated with the highest risk for potential DRPs.


CONCLUSIONS
In this vulnerable group of elderly patients potential DRPs frequently occur. Community pharmacists can play an important role in the identification, assessment and prevention of potential DRPs in the elderly. It is useful to investigate which part of potential DRPs can be avoided by the intervention of the community pharmacist in collaboration with the prescriber and the patient.
Vinks
Thijs H A M
TH
Brabant Institute for Pharmaceutical Research and Development (BIRD), Tilburg, The Neterlands.
de Koning
Fred H P
FH
de Lange
Ton M
TM
Egberts
Toine C G
TC
D000368:Aged; D000369:Aged, 80 and over; D003157:Community Pharmacy Services; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008297:Male; D010595:Pharmacists; D019338:Polypharmacy; D024382:Professional Role