단일 상급종합병원에서 노인 환자의 다제약물 복약상담 현황

Abstract

Background : Elderly patients have a high rate of polypharmacy due to the increased prevalence of chronic diseases. Polypharmacy can increase the risk of poor drug compliance, drug-related problems (DRPs), and potentially inappropriate medication (PIM) use. Therefore, the purpose of this study was to present a direction to improve polypharmacy management for the elderly by analyzing the status and results of polypharmacy counseling for the elderly. Methods : A retrospective medical record review study was conducted from September 2021 to August 2022 based on the polypharmacy counseling records at a tertiary hospital. DRPs were analyzed using Pharmaceutical Care Network Europe (PCNE) Classification version 9.1. PIMs were compared before and after polypharmacy counseling using the screening tools for older person’s potentially inappropriate prescriptions (STOPP). Results : The median age of the 46 included patients was 80.5. The median number of drugs administered was 16. The median number of DRPs was two, and 63% of the patients were using PIMs based on STOPP. Among 115 cases of DRPs, ‘adverse drug event (possibly) occurring’ accounted for the most (68.7%). Among the causes of 124 DRPs, ‘drug selection’ accounted for the most (71.8%). The 378 interventions were in the order of the patient level’ (48.4%), the prescriber level’ (30.4%), and the drug level’ (21.2%), and the intervention acceptance rate was 87.8%. After counseling, 86.9% of the DRPs were completely or partially resolved. PIMs based on STOPP decreased from 45 to 39 cases. In particular, the unnecessary use of proton pump inhibitors (PPIs) decreased the most. Conclusion : Most DRPs and PIMs were resolved through various interventions by pharmacists. The pharmacist’s role in continuously monitoring medications for elderly patients after polypharmacy counseling is important and should be expanded further.