Prevalence of medication-related problems in complex chronic patients and opportunities for improvement

Abstract

Objective: To estimate the prevalence of medication-related problems in patients treated in continuous care units and to identify the therapeutic areas in which these problems were more concentrated. Method: Observational descriptive prospective study. Review of clinical histories and outpatient treatment by a hospital pharmacist. Communicating medication-related problems detected to the responsible doctor. Analysis of the therapeutic areas in which the problems were most concentrated. Results: 85 patients were reviewed, and 368 potential medication-related problems were identified. The areas with the most prevalent medication- related problems were the long-term use of hypnotics, sub-optimal analgesia, optimizable antidepressant treatment, statins in patients older than 75 years in primary prevention and in those with high-intensity doses in secondary prevention, patients with heart failure without angiotensin-converting enzyme inhibitors, and proton-pump inhibitors without indication. Conclusions: Training interventions should be implemented and computer assistance should be developed to help avoid the most prevalent medication-related problems.

Keywords

• Primary Health Care
• Continuity of patient care
• Chronic disease
• Comorbidity
• Intermediate care
• Medication-related problems