노인의료센터 다학제 팀의 약물 조정이 약물사용 및 약제비 절감에 미치는 효과
The Effects of Medication Reconciliation on Drug Use and Cost-Saving by Multidisciplinary Geriatric Care Team
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Background : Older adults tend to experience multiple chronic conditions on polypharmacy with consequent increase in adverse drug events and medication costs, requiring more medication reconciliation. To date, the effects of medication reconciliation for the inpatients by geriatric pharmacists in multidisciplinary teams have been rarely known in Korea. The purpose of this study was to assess the effects of medication reconciliation by analyzing the changes in prescription and reductions in medication costs for inpatients who received multidisciplinary team care. Methods : Records of patients age 65 and older, admitted to the geriatric center July 1, 2016-June 30, 2017, were retrospectively analyzed in this study. The list of the medications prior to the admission and upon the hospital discharge was obtained from the comprehensive geriatric assessment and electronic medical records, respectively to assess the reduction of the total number of medications, drug duplication, and potentially inappropriate medications (PIM). The cost of drugs was calculated by multiplying the daily price of medicine by the number of days of medication. Results : The mean age of 300 patients was 83.7 (SD 6.9), and 38.7% were males. The patients taking five or more medications were 87.3% before the admission, and 45.0% were mainly diagnosed with infectious disease at admission. With the medication reconciliation, the mean number of medication per patients decreased 10.5 (SD 5.0)-6.5 (SD 3.4) (p 0.001). The number of patients who received the medications listed under PIMs and duplicated was reduced 227-114, and 59-3, respectively (all p 0.001). A total of 458,573 won was saved per person through medication reconciliation. Conclusions : The multidisciplinary team care with the geriatric pharmacist led to safer and more appropriate medication therapy. As a result, it subsequently improved patient safety and medication cost-saving for geriatric patients
Abstract
Background : Older adults tend to experience multiple chronic conditions on polypharmacy with consequent increase in adverse drug events and medication costs, requiring more medication reconciliation. To date, the effects of medication reconciliation for the inpatients by geriatric pharmacists in multidisciplinary teams have been rarely known in Korea. The purpose of this study was to assess the effects of medication reconciliation by analyzing the changes in prescription and reductions in medication costs for inpatients who received multidisciplinary team care. Methods : Records of patients age 65 and older, admitted to the geriatric center July 1, 2016-June 30, 2017, were retrospectively analyzed in this study. The list of the medications prior to the admission and upon the hospital discharge was obtained from the comprehensive geriatric assessment and electronic medical records, respectively to assess the reduction of the total number of medications, drug duplication, and potentially inappropriate medications (PIM). The cost of drugs was calculated by multiplying the daily price of medicine by the number of days of medication. Results : The mean age of 300 patients was 83.7 (SD 6.9), and 38.7% were males. The patients taking five or more medications were 87.3% before the admission, and 45.0% were mainly diagnosed with infectious disease at admission. With the medication reconciliation, the mean number of medication per patients decreased 10.5 (SD 5.0)-6.5 (SD 3.4) (p 0.001). The number of patients who received the medications listed under PIMs and duplicated was reduced 227-114, and 59-3, respectively (all p 0.001). A total of 458,573 won was saved per person through medication reconciliation. Conclusions : The multidisciplinary team care with the geriatric pharmacist led to safer and more appropriate medication therapy. As a result, it subsequently improved patient safety and medication cost-saving for geriatric patients
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