The high rate chronic problems of elderly patients attributes to various drug-related problems (DRP). It was a prospective observational study where eligible  ‎Abstract · ‎INTRODUCTION · ‎RESULTS · ‎DISCUSSION. Definition and classification of drug-related problems. The expert panel agreed on adapting the definition of DRPs provided by the Pharmaceutical Care Network Europe: «An event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes» (15). PREVENTING MEDICATION-RELATED PROBLEMS WEBINAR Dec 5, .


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OTC over-the-counter The clinical pharmacist participated in ward rounds, and clinically relevant DRPs were discussed with the health care team physicians, nurses, enrolled nurses.


Advice was given about drug selection, dosages, and possible monitoring needs. When a drug was medication related problems inappropriate for some reason, alternative drugs were suggested. The attending physicians made the final decision concerning proposed changes to therapy.


ADR, dosage too high, dosage too low, ineffective drug, needs additional drug therapy, unnecessary drug therapy and noncompliance.

Inappropriate medication related problems were added to the category ineffective drugs and, additionally, three further categories were introduced: These three extra categories were classified as ADRs in the main paper [ 13 ].

The DRPs were defined as follows: Adequate doses resulting in adverse drug reactions were classified as ADR.


If the prescribed dose was less than recommended, this was classified as dosage too low. Needs additional drug therapy: If a patient was inadequately medicated, this was classified as needs additional drug therapy. If a patient had an unnecessary drug therapy, this medication related problems classified as unnecessary drug therapy.

Inadequate monitoring Documenting the indication for a new drug Keeping a current list of drugs used by the patient in medical records Monitoring for achievement of therapeutic goals and other responses to new drugs Monitoring medication related problems laboratory tests for efficacy or adverse effects Periodically reviewing drugs for continued need Such measures are especially important for elderly patients.

Assessment of Medication-Related Problems in Geriatric Patients of a Rural Tertiary Care Hospital

Lack of close monitoring, especially after new drugs are prescribed, increases risk of adverse effects and ineffectiveness. Criteria to facilitate monitoring medication related problems been developed by the Health Care Financing Administration expert consensus panel as part of drug utilization review criteria.

The criteria focus on inappropriate dosage or duration of therapy, duplication of therapy, and possible drug-drug interactions. Inappropriate drug selection A drug is inappropriate if its potential for harm is greater than its potential for benefit.

Some classes of drugs are of special concern in the elderly see Drug Categories of Concern in the Elderly. Some drugs are so problematic that they should be avoided altogether in the elderly, some should be avoided only in certain situations, and others can be used but with increased caution.

The Beers Criteria see Drug-Disease Interactions in the Elderly Based on the American Geriatrics Society Beers Criteria Update lists potentially inappropriate drugs for the elderly by drug class; other similar lists are available.

The classification is a tool to handle challenges in relation medication related problems drug medication related problems and the system could contribute to improved documentation of various problem areas.

Drug-Related Problems in the Elderly - Geriatrics - MSD Manual Professional Edition

Consensus-based procedures are suitable for integration of research-based and experience-based knowledge. Medication related problems modified Delphi technique is an established method for development of clinical guidelines and quality indicators Communication by e-mail enables participation of experts who are geographically far apart.

On the other hand, the method is demanding and lack of discussion may medication related problems identification of good ideas and elimination of bad ones.

Van Mil and collaborators have assessed 14 published classification systems of DRPs The group points out that classification systems should be validated and also that the results of this procedure should be published.

Assessment of Medication-Related Problems in Geriatric Patients of a Rural Tertiary Care Hospital

However, only a few of medication related problems classifications have been validated. We have gone through a case-based validation procedure among a heterogeneous review panel to assess the content of the classification and to reveal medication related problems face.

The classification system has an open hierarchical structure that can be adapted and expanded with several categories according to need, setting and access to clinical information.

The intention was to construct a general model that comprises many different problem areas and at the same time prioritize simplicity and flexibility rather than in depth detailed descriptions.