Hospital Admissions Associated With Medication-Related Problems in Thai Older Patients: A Multicenter Prospective Observational Study. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Dechanont, Supinya; Jedsadayanmata, Arom; Butthum, Bodin; Kongkaew, Chuenjid
• Is Part Of: Journal of patient safety. Volume 17:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: hospital admissions -- medication-related problems -- preventable -- older patients -- Thailand; Patients -- Safety measures -- Periodicals; Medicine -- Practice -- Safety measures -- Periodicals; Medical errors -- Prevention -- Periodicals; 610.289
• DOI: 10.1097/PTS.0000000000000627
• Languages: English
• ISSNs: 1549-8417

Abstract

Abstract : Objective: The aim of the study was to estimate the prevalence rate and risk factors of medication-related problems (MRPs) leading to hospital admissions in Thai older patients. Methods: A prospective observational study was carried out in nine hospitals in Lower Northern Thailand. Participants admitted to internal medicine units were screened for suspected MRPs by clinical pharmacists using medical record review and patient interview. Three experts evaluated suspected MRPs independently using the following four criteria: contribution of MRPs to hospital admissions, causality, severity, and preventability. Results: Of 1776 patients admitted during the study period, 56 patients (3.2%) were deemed to have causal MRPs; 24 (42.9%) were judged as preventable. The medication groups most commonly associated with MRPs were those targeting the endocrine system, especially antidiabetic medications, such as metformin and glipizide. Preventable MRPs were usually manifest as hypoglycemia (n = 15, 62.5%). The variables that contributed to hospital admissions associated with MRPs were age (odds ratio = 1.92; 95% confidence interval [CI] = 1.06–3.47), starting a new drug within 1 week (odds ratio = 2.31; 95% CI = 1.08–4.95), or within 1 month (odds ratio = 2.17; 95% CI = 1.05–4.48). Conclusions: Hospital admissions associated with MRPs in Thai older patients continue to burden the Thai healthcare system of which nearly half were preventable. Further studies should consider analysis of costs and include hepatic and renal function status of participants.