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KMID : 0869620140310010629
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Journal of Korean Society of Hospital Pharmacists
2014 Volume.31 No. 1 p.629 ~ p.637
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Assessment of Medications for Geriatric Inpatients based on Revised Inappropriate Medication Criteria and Cost Avoidance by Intervention of Pharmacists
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Lee Jong-Hye
Roh Ju-Hyun
Suh Ye-Won
Lee Jeong-Hwa
Lee Eun-Sook
Lee Byoung-Koo
Kim Kwang-Il
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Abstract
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The purpose of the Geriatric Center (GC) in Seoul National University Bundang Hospital (SNUBH) is to provide comprehensive care to geriatric patients using comprehensive geriatric assessment (CGA) tool. Pharmacists in the center perform medication intervention using the Potentially Inappropriate Medications (PIMs) list consolidated by SNUBH based on the Beers criteria of 2003. In 2012, the list was revised based on the Screening Tool of Older Person’s Prescriptions (STOPP) criteria of 2008 and the Beers criteria of 2012. In this study, we assessed the medication for the inpatients in the center based on the revised SNUBH inappropriate medication criteria 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 in 2012, were involved in this study. The median age of the patients was 82.2 years old: Among them, 46.1% of the patient had more than four diseases, 70.1% of the patient had adequate drug compliance, and 19.1% of the patient experienced drug adverse events. There were differences in the 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 as the result of the reduction in the number, the percentage of patients who received the medications listed under PIMs and duplicated drugs was also significantly decreased from 58.4% to 31.4% and from 21.3% to 1.1%, respectively. In total, 336 clinical interventions were performed by the pharmacists: The most frequent types of the intervention were related to the identification of potential drug adverse events and drug-drug interaction, suggesting that the prescription in geriatric patients can be significantly improved in many respects by pharmacists’medication assessment and intervention. More importantly, the cost avoidance as the result of the intervention was found to ＼52,216,666.2. Since Korea represents the one of the most rapidly aging societies in the world, the intervention of pharmacists can serve as the practical means for medical cost-saving in Korea.
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KEYWORD
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Inappropriate medication criteria for elderly, Elderly patients, Medication intervention by pharmacist, Cost avoidance
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