Identification of Drug Therapy Problems among Elderly in-patients of a Nigerian Teaching Hospital

Abstract

Categorizing and identifying drug related problems will enable the practitioner with the co-operation of the patient to construct a care plan to resolve the drug therapy problems (DTPs). The aim of this study was to investigate the occurrence of drug related problems among elderly in-patients and to identify those at risk of DTPs. A two-fold study combining retrospective and prospective was carried out in a teaching hospital using elderly inpatients prescriptions and self assessment questionnaires. Ninety in-patient prescriptions (from case notes) were randomly selected for the retrospective study. Majority of the patients were males 54(60%). Most occurring disease was diabetes mellitus 9 (10.5%) followed by hypertension 8 (9.3%). Major therapeutic groups associated with drug related problems were cardiovascular drugs 113 (21.5%) and central nervous system drugs 92 (17.5%). Promethazine 7 (33.3%) occurred most as a potentially inappropriate medication using the Beers Criteria. Drug related admissions was 12 (13.3%) while drug related problems that occurred include major Polypharmacy 60 (66.7%), unnecessary drug therapy 29 (32.2%), adverse drug reactions 28 (31.1%), need for additional therapy 27 (30%) and non compliance 13 (14.4%). Twelve inpatients were assessed for the prospective study. Hypertension 5 (26.3%) was the highest diagnosis. Out of the 120 responses of the self assessment questionnaire, 99 (82.5%) were ‘No’ indicating a reduced risk. Drug therapy problems were evident in this survey especially in the retrospective study. This calls for pharmaceutical care intervention in the elderly.

Keywords: Drugs, Problems, Elderly in-patients

Nigerian Journal of Pharmaceutical Research, Vol. 9 No 1 pp. 49 – 56 (February 2011)