개정된 원내 노인부적절약물 목록을 활용한 입원환자의 약물 평가 및 임상적 중재에 의한 회피비용 분석
Assessment of Medications for Geriatric Inpatients based on Revised Inappropriate Medication Criteria and Cost Avoidance by Intervention of Pharmacists
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초록
The purpose of the Geriatric Center (GC) in Seoul National University BundangHospital (SNUBH) is to provide comprehensive care to geriatric patients using comprehensivegeriatric assessment (CGA) tool. Pharmacists in the center perform medication intervention usingthe Potentially Inappropriate Medications (PIMs) list consolidated by SNUBH based on the Beerscriteria of 2003. In 2012, the list was revised based on the Screening Tool of Older Person’sPrescriptions (STOPP) criteria of 2008 and the Beers criteria of 2012. In this study, we assessedthe medication for the inpatients in the center based on the revised SNUBH inappropriate medicationcriteria of 2012 to evaluate economic outcomes of pharmacists’interventions in terms of the prospect of cost avoidance. Eighty nine patients, admitted the SNUBH GC during the period of March 1st to August 31st in2012, were involved in this study. The median age of the patients was 82.2 years old: Amongthem, 46.1% of the patient had more than four diseases, 70.1% of the patient had adequate drugcompliance, and 19.1% of the patient experienced drug adverse events. There were differences inthe prescription prior to hospitalization in comparison to that at their discharge. In this comparison,we found that the median number of medication was decreased from 9.4 to 6.3: Probably asthe result of the reduction in the number, the percentage of patients who received the medicationslisted under PIMs and duplicated drugs was also significantly decreased from 58.4% to31.4% and from 21.3% to 1.1%, respectively. In total, 336 clinical interventions were performed bythe pharmacists: The most frequent types of the intervention were related to the identification ofpotential drug adverse events and drug-drug interaction, suggesting that the prescription ingeriatric patients can be significantly improved in many respects by pharmacists’medicationassessment and intervention. More importantly, the cost avoidance as the result of the interventionwas found to ＼52,216,666.2. Since Korea represents the one of the most rapidly aging societiesin the world, the intervention of pharmacists can serve as the practical means for medicalcost-saving in Korea.
Abstract
The purpose of the Geriatric Center (GC) in Seoul National University BundangHospital (SNUBH) is to provide comprehensive care to geriatric patients using comprehensivegeriatric assessment (CGA) tool. Pharmacists in the center perform medication intervention usingthe Potentially Inappropriate Medications (PIMs) list consolidated by SNUBH based on the Beerscriteria of 2003. In 2012, the list was revised based on the Screening Tool of Older Person’sPrescriptions (STOPP) criteria of 2008 and the Beers criteria of 2012. In this study, we assessedthe medication for the inpatients in the center based on the revised SNUBH inappropriate medicationcriteria of 2012 to evaluate economic outcomes of pharmacists’interventions in terms of the prospect of cost avoidance. Eighty nine patients, admitted the SNUBH GC during the period of March 1st to August 31st in2012, were involved in this study. The median age of the patients was 82.2 years old: Amongthem, 46.1% of the patient had more than four diseases, 70.1% of the patient had adequate drugcompliance, and 19.1% of the patient experienced drug adverse events. There were differences inthe prescription prior to hospitalization in comparison to that at their discharge. In this comparison,we found that the median number of medication was decreased from 9.4 to 6.3: Probably asthe result of the reduction in the number, the percentage of patients who received the medicationslisted under PIMs and duplicated drugs was also significantly decreased from 58.4% to31.4% and from 21.3% to 1.1%, respectively. In total, 336 clinical interventions were performed bythe pharmacists: The most frequent types of the intervention were related to the identification ofpotential drug adverse events and drug-drug interaction, suggesting that the prescription ingeriatric patients can be significantly improved in many respects by pharmacists’medicationassessment and intervention. More importantly, the cost avoidance as the result of the interventionwas found to ＼52,216,666.2. Since Korea represents the one of the most rapidly aging societiesin the world, the intervention of pharmacists can serve as the practical means for medicalcost-saving in Korea.
참고문헌 (15)
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