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KMID : 0869620070240020115
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Journal of Korean Society of Hospital Pharmacists
2007 Volume.24 No. 2 p.115 ~ p.123
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Jung Hyun
Suh Ye-Won
Jeon Su-Jeong
Lee Eun-Sook
Lee Byoung-Koo
Kim Kwang-Il
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Abstract
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Recently, the number of geriatric patients is increasing. However, absence of exact pharmacotherapy policies for geriatric patients leads to increased risk of inappropriate medication use. In Seoul National University Bundang Hospital(SNUBH), Geriatric Center where pharmacists participate was established to prevent inappropriate medication use in geriatric patients. In order to evaluate general pharmacotherapy for geriatric patients, a study of polypharmacy and inappropriate medication use in community-dwelling geriatric patients was performed in 2004. In this study, we examined the extent and trend of inappropriate medication use in hospitalized geriatric patients to assure the quality of pharmacotherapy and provide information to the medical team. Data of inappropriate medication use in the geriatric patients who admitted at between January 1st and June 30th in 2006 were obtained from Electronic Medical Record (EMR) retrospectively. We set the criteria for inappropriate medication based on Beer’s criteria(2002) and Zhan’s classification(2001). Various demographical and therapeutic variables (i.e., the age, gender, medical department, daily dosage of medication prescribed, duration of medication use) were compiled for analyzing the inappropriate medication use. Out of total of 20,025 admitted patients, hospitalized geriatric patients were 5,498(27.5%). Among them, the patients who received prescription of inappropriate medications were 2,350(42.7%). Also, 639 patients received more than two inappropriate medications. Based on Beer’s criteria, high risk medications(92.6%) were prescribed more than low risk medications(7.4%). The most frequently prescribed medications were ketorolac(30%), pethidine(27.8%), and diazepam(16.0%). Medical departments which prescribed the most frequently were cardiovascular center(19.7%), general surgery(12.8%), internal medicine of gastroenterology(12.5%). But the relative ratio to the number of geriatric inpatients of each department was high in cardiovascular center(74.4%), joint disease and reconstruction center(69.5%), internal medicine of gastroenterology(59.0%). In Geriatric center, 28.3% of patients received inappropriate medications. Generally, the severity of disease of inpatients is so serious that inappropriate medication use in inpatients is more prevalent than in outpatients. This result may be due to medical team’s overlooking, lack of available drugs to substitute and so on. In conclusion, establishment of exact pharmacotherapy policies for geriatric patients and close attention of medical team are required.
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KEYWORD
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Geriatric patient, hospitalized, community-dwelling geriatric patients, inappropriate medication, the Beer‘s Criteria, Zhan’s classification, polypharmacy, EMR
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