Pharmacy tools for screening high risk medication problems
to geriatric inpatients
Mi-ri-nae Leeo, Ju-won Jung, Hye-won Han, Jae-yeon Kim
Department of Pharmacy, Asan Medical Center
[Purpose]
In ageing society, geriatric patients are increasing and they are weak for adverse drug reaction because of multiple medications. Thus hospital pharmacists need reliable screening tool for detecting high risk medication problems promptly. We designed PREdictive Screening Tool of Medication problems (PREST-M) and applied with geriatric inpatients. This study aimed to evaluate predictive screening tool for medication problems or Potentially Inappropriate Prescribing (PIP) incidence.
[Methods]
The PREST-M is designed referring to previous issued literature about patient prioritization tool. This tool assigned weighted risk score for 5 categories: High risk age, patient history of medical attention, comorbid diseases requiring close monitoring, high-risk medication, and laboratory value.
We included patients over 65 years admitting pulmonary general ward. We applied this tool to geriatric inpatients within 48 hours after admission. PIP is defined according to Beer’s criteria and STOPP/START criteria. Adverse drug reactions (ADR) were assessed by a pharmacist. It could also be reported by staff physicians and nurses.
[Results]
Patients assessed by PREST-M were 284 including 205 males and 79 females. The mean age was 75. The average number of medicines was 8.5 and the mean period of hospitalization was 7.7 days.
Given highest risk scores for each factor, the total PREST-M score will be 128. The final score ranged from 10 to 68. We classified the groups as follows: Low-risk group (score < 20), middle-risk group (score ≥ 20, < 40), and high-risk group (score > 40). The analysis revealed high association of risk tool scores with PIP and ADR incidence.
[Conclusion]
The developed PREST-M is reliable for predicting PIP and ADR.
[Keywords]
Geriatric, Screening tool, Potentially inappropriate prescribing, Adverse drug reaction
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