Research Journal of Pharmacy and Technology

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Impact of Clinical Pharmacist Intervention towards Polypharmacy in Elderly population-A Systematic Study


Affiliations
1 Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
     

   Subscribe/Renew Journal


Polypharmacy is a common practice in elderly patients afflicted with multiple chronic conditions and is also one of the reason for various consequences like increased incidence of adverse drug reactions, decreased medication adherence and quality of life. In order to improve this condition the pharmacists have taken certain interventional measures like Medication therapy management services, educational interventions for patients. These interventions have decrease the total number of drugs taken in addition to the number of doses taken per day, decrease in the ADR, increase in medication adherence. Our objective was to carry out a study which could assess the impact of Clinical Pharmacist interventions towards polypharmacy in elderly population. A systematic study was carried out in which we included 12 articles published in MEDLINE from a period of 2010-2017.The keywords used to carry out the search were polypharmacy, intervention, deprescribing, economic outcome. Interventions were carried out on a total of 3998 patients studied from the 12 articles, we observed that 1554 patients (10 studies) showed an improvement in Clinical outcomes, whereas Humanistic outcomes were improved in 911 patients (4 studies), economic outcomes were improved in about 2694 patients (6 studies).Our study concludes that interventions carried out by pharmacist to reduce polypharmacy had a beneficial impact in the improvement on the health-care of the elderly populations.

Keywords

Polypharmacy, Intervention, Clinical Outcomes, Economic Outcomes, Humanistic Outcomes, Elderly.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Kaufman D, Kelly J, Rosenberg L, Anderson T, Mitchell A. Recent Patterns of Medication Use in the Ambulatory Adult Population of the United States. JAMA. 2002, 287(3): 337.doi: 10.1001/jama.287.3.337

  • Gorard D. Escalating polypharmacy. QJM. 2006, 99(11):797-800. Doi: 10.1093/qjmed/hcl109.

  • Sembian N. Polypharmacy and its Management. Research J. Pharm. and Tech. 7(3): Mar., 2014; Page 335-339.

  • UofL Health Care Outpatient Center401 E. Chestnut St., Ste 170 Louisville, KY 40202.

  • Bjerrum, L., J.U. Rosholm, J. Hallas, and J. Kragstrup, Methods for estimating the occurrence of polypharmacy by means of a prescription database. Eur J Clin Pharmacol, 1997. 53(1): p. 7-11.

  • Fulton M, Riley Allen E. Polypharmacy in the elderly: A literature review. Journal of the American Academy of Nurse Practitioners. 2005;17(4):123-132. Doi: 10.1111/j.1041-2972.2005. 0020. x

  • Frazier S. Health Outcomes and Polypharmacy in Elderly Individuals. Journal of Gerontological Nursing. 2005, 31(9): 4-9.doi: 10.3928/0098-9134-20050901-04

  • Yvette, & Terrie. (2004, December 1). Understanding and Managing Polypharmacy in the Elderly. Retrieved January 26, 2014, from Pharmacy Times: http://www.pharmacytimes.com/publications/issue/2004/2004-12/2004-129094#sthash.TGVVlb8J. dpuf 295: 35

  • Gurwitz, R. (1995, July 1). Drug Therapy. Lancet, 346, 32-36

  • National prescribing Service Limited (NPS). (2010, August ). Medicine Update Vildagliptin (Galvus) for type 2 diabetes. Retrieved March 30, 2014, from NPS Web site: www.nps.org.au/_data/assets/pdf_file/0009/106578/NPS_Medicine_Update_Vildagliptin_August 2010.pdf 923: 45

  • Partha Pratim Mahata, Abhimanyu Thakur, Samprita Chakraborty, Nripendra Nath Bala. A Review on Pharmacist’s Role in Mitigation of Food- Drug Interactions. Research J. Pharm. and Tech. 8(4): April, 2015; Page 423-431.

  • Shivangee Sabharwal, Reetuparna Mukherjee, Ayush Shukla, Tamizharasi, Mythili T. Indoor Assistance for Elderly and Disabled People. Research J. Pharm. and Tech. 2017; 10(7): 2163-2172.

  • Sonali S. Sangrulkar. An Exploratory Study to Identify Problems Related to old age and Adaptive Strategies used by Elderly from a Selected Urban Community in a Metropolitan City of Maharashtra. Int. J. Adv. Nur. Management 3(3): July- Sept. 2015; Page 259-266.

  • G. Vimala, R. C. Goyal. Quality of life of elderly in India: A Review. Int. J. Nur. Edu. and Research. 2018; 6(4): 425-430.

  • Rochon PA, Gurwitz JH. Optimising drug treatment for elderly people: The prescribing cascade. BMJ. 1997, 315(7115):1096–9.

  • Denison, s. M. (2010). Interventions to improve prescribing quality in care homes: a systematic review. Epidemiol community health, 64: 43-44.

  • Chitra Jose, Monica Antony, Jyothi Goutham Kumar, Maheswari C, Venkatanarayanan R, Sam Johnson Udaya Chander J. Conceptual and Practical Update on Drug-Drug Interactions. Research J. Pharm. and Tech. 9(1): Jan., 2016; Page 60-68.

  • T. Tamilselvan, Arokia Rani C., Ashna Raj, Leena Priya M., Nissy Varghese, Sojan P. Paul. Prescription Analysis of Antiepileptic Drugs in a Tertiary Care Hospital. Asian J. Pharm. Tech. 2018; 8 (1):43-46.

  • Jagadeesan M, Manikandan R, Nandamuri Sri Sai Sudha. The Drug-Drug Interactions: Affecting the Rationality of Prescriptions. Research J. Pharm. and Tech 2018, 11(7): 3077-3080.

  • Ballentine N. Polypharmacy in the elderly: maximizing benefit, minimizing harm. Crit Care Nurs Q. 2008, 31:40-45.

  • Robert L. et al. Clinical consequences of polypharmacy in elderly. Expert Opin Drug Saf. 2014 January, 13(1): doi:10.1517/14740338.2013.827660.

  • Marvin V, Ward E, Poots AJ, et al Deprescribing medicines in the acute setting to reduce the risk of falls Eur J Hosp Pharm 2017;24:10-15.

  • Twigg MJ et al. The four or more medicines (FOMM) support service: results from an evaluation of a new community pharmacy service aimed at over-65s. Int J Pharm Pract. 2015 Dec;23(6):407-14. doi: 10.1111/ijpp.12196.

  • Ocampo CC et al. Implementation of medication review with follow-up in a Spanish community pharmacy and its achieved outcomes. Int J Clin Pharm. 2015 Oct;37(5):931-40. doi: 10.1007/s11096-015-0145-9.

  • Reeve E.et al. Feasibility of a patient-centered deprescribing process to reduce inappropriate use of proton pump inhibitors. Ann Pharmacother. 2015 Jan;49(1):29-38. doi: 10.1177/1060028014558290.

  • Ilić D. et al. Impact of Educational Intervention on Prescribing Inappropriate Medication to Elderly Nursing Homes Residents. Srp Arh Celok Lek. 2015 Mar-Apr;143(3-4):174-179

  • Sakakibara M. et al. Effects of Prescription Drug Reduction on Quality of Life in Community-Dwelling Patients with Dementia. J Pharm Pharm Sci. 2015;18(5):705-12.

  • Runganga M, Peel NM, Hubbard RE. Multiple medication use in older patients in post-acute transitional care: a prospective cohort study. Clin Interv Aging.2014 Sep 2;9:1453-62.

  • Ma JD1, Tran V2, Chan C2, Mitchell WM3, Atayee RS4. Retrospective analysis of pharmacist interventions in an ambulatory palliative care practice. J Oncol Pharm Pract. 2016 Dec;22 (6): 757-765.

  • Becerra V, Gracia A, Desai K, et al Cost-effectiveness and public health benefit of secondary cardiovascular disease prevention from improved adherence using a polypill in the UK BMJ Open 2015;5:e007111. doi: 10.1136/bmjopen-2014-007111.

  • H. Shiao. Pharmaceutical Care Patients of Chronic Diseases with Polypharmacy and Cost Saving. ISPOR. 2014 November:17(7): A763

  • Lin HW. Economic outcomes of pharmacist-physician medication therapy management for polypharmacy elderly: A prospective, randomized, controlled trial. J Formos Med Assoc. 2017 May 23. pii: S0929-6646(17)30352-2. doi: 10.1016/j.jfma.2017.04.017.

  • Brophy L. et al. Collaborative DTM reduces hospitalization and healthcare costs in patients with diabetes treated with polypharmacy. Am J Manag Care. 2014 Mar 1;20(3):e72-81

  • Malet-Larrea A. et al. Cost analysis and cost-benefit analysis of a medication review with follow-up service in aged polypharmacy patients. Eur J Health Econ. 2016 Dec 2.

  • S Lincy, M Greeshma, E Maheswari, S Tharanath, Subeesh Viswam. An Empirical Study to assess the Pattern and Predictors of Adverse Drug Reactions associated with Polypharmacy in the Department of General Medicine. Research J. Pharm. and Tech 2018; 11(11): 5042-5048.

  • Abdullahi Rabiu Abubakar, Nordin Bin Simbak, Mainul Haque. Adverse Drug Reactions: Predisposing Factors, Modern Classifications and Causality Assessment. Research J. Pharm. and Tech. 7(9): Sept. 2014 Page 1091-1098.


Abstract Views: 289

PDF Views: 0




  • Impact of Clinical Pharmacist Intervention towards Polypharmacy in Elderly population-A Systematic Study

Abstract Views: 289  |  PDF Views: 0

Authors

Ayesha Siddiqua
Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
Ruba Khalid Abdullah
Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
Najla Abdul Kareem
Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia

Abstract


Polypharmacy is a common practice in elderly patients afflicted with multiple chronic conditions and is also one of the reason for various consequences like increased incidence of adverse drug reactions, decreased medication adherence and quality of life. In order to improve this condition the pharmacists have taken certain interventional measures like Medication therapy management services, educational interventions for patients. These interventions have decrease the total number of drugs taken in addition to the number of doses taken per day, decrease in the ADR, increase in medication adherence. Our objective was to carry out a study which could assess the impact of Clinical Pharmacist interventions towards polypharmacy in elderly population. A systematic study was carried out in which we included 12 articles published in MEDLINE from a period of 2010-2017.The keywords used to carry out the search were polypharmacy, intervention, deprescribing, economic outcome. Interventions were carried out on a total of 3998 patients studied from the 12 articles, we observed that 1554 patients (10 studies) showed an improvement in Clinical outcomes, whereas Humanistic outcomes were improved in 911 patients (4 studies), economic outcomes were improved in about 2694 patients (6 studies).Our study concludes that interventions carried out by pharmacist to reduce polypharmacy had a beneficial impact in the improvement on the health-care of the elderly populations.

Keywords


Polypharmacy, Intervention, Clinical Outcomes, Economic Outcomes, Humanistic Outcomes, Elderly.

References