ABSTRACT
Objective To explore the effect of polypharmacy assessment and intervention on elderly inpatients mainly in both economy and safety. Methods One hundred and forty elderly inpatients were selected. Fifty patients took less than 5 drugs, 75 patients took 5- 9 drugs, and 15 patients took more than 10 drugs. According to medication appropriateness index (MAI) and Beers criteria, the polypharmacy of elderly inpatients was assessed and intervened. The results were compared before and after intervention. Results The discrepancy rate of Beers criteria, incidence of potential risk, total scores of prescription MAI and average daily drug cost after intervention were significantly lower than that before intervention: 7.14% (10/140) vs. 16.43% (23/140), 22.14% (31/140) vs. 90.71%(127/140), 0(0,0)scores vs. 6.00(2.25,10.00)scores and (30.60 ± 19.71) yuan vs. (35.34 ± 26.84) yuan, and there were statistical differences (P<0.01 or <0.05). Conclusions Irregular medication exists widely in elderly patients, and the polypharmacy assessment and intervention can lighten the financial burden of elderly patients and improve the safety of drug therapy.
ABSTRACT
Background: The emergence of antibiotic resistance is a complex problem contributed by the interplay of various parties such as prescribers, patients or health settings. In particular, prescribers play a vital role in the use of antibiotics both in rational prescribing of drugs and influencing patients on the appropriate use. Objectives: Determine the appropriateness of the higher generation antibiotics (cephalosporin and flouroquonolone groups) in the out-patient setting of Bhutan hospitals. Materials and method: A cross-sectional study was conducted in three referral hospitals of Bhutan where the prescriptions were collected from the pharmacy. All prescriptions containing higher generation antibiotics were selected based on the appropriateness using a modified Medication Appropriateness Index. Three hundred thirty three prescriptions containing higher generation antibiotics were analyzed. Results: The use of antibiotics was common with 37.1% of the prescriptions containing antibiotics out of which 14% were higher generation antibiotics. When assessed on the appropriateness of the prescription, 55.9% of the prescriptions containing higher generation antibiotics were prescribed inappropriately. In addition, only 47.1% of the prescriptions had appropriate indications for higher generation antibiotics. Conclusion: There is a widespread inappropriate use of higher generation antibiotics in Bhutan.