An assessment of drug related problems in the elderly in the community and methodology for their prevention.

Cunningham, Gillian

Abstract

Although drug related problems (DRPs) are known to be prevalent in the elderly, literature on prevention of iatrogenic disease is sparse. In addition, difficulties in interpreting and comparing study data on DRPs are experienced due to differences in data collection methods, and the lack of standardised criteria for identification and assessment. The present study attempts to address these needs, by assessing the incidence of DRPs in elderly patients admitted to hospital according to standardised definitions, before and after implementation of preventive strategies. One thousand and eleven elderly patient admissions to Tayside hospitals were studied in the first phase. The incidence of DRPs was 144/1011 (14.2%), with 54/1011 (5.3%) of the admissions identified as being ‘definitely’ or ‘probably’ drug related. Non-steroidal anti-inflammatory drugs (NSAIDs) were the main drug group involved, being responsible for 15/54 (28%) of admissions primarily due to a DRP. Over 66% of admissions due to adverse effects of NSAIDs were considered to be ‘definitely preventable’, and a further 27% ‘possibly preventable’. Intervention strategies targeted this group of drugs and comprised an educational bulletin aimed at GPs in Tayside region, a patient information leaflet distributed through community pharmacists, and an oral presentation to trainee GPs. A second phase of data collection took place immediately after the interventions to assess the effects of the strategies on the DRPs targeted. A statistically significant drop in NSAID prescribing in Tayside compared to the rest of Scotland was observed. Although the strategies were not demonstrably effective in reducing the number of admissions due to adverse effects of NSAIDs, there did seem to be an improvement in the first 4 months after their implementation. Repeated reminders of the suggested improvements in prescribing are probably required, to limit NSAID use. The study results lend further weight to the case for reducing and rationalising the prescription of NSAIDs to elderly patients.

Citation

CUNNINGHAM, G. 1995. An assessment of drug related problems in the elderly in the community and methodology for their prevention. Robert Gordon University, PhD thesis. Hosted on OpenAIR [online]. Available from: https://doi.org/10.48526/rgu-wt-2807345

• Thesis Type: Thesis
• Deposit Date: Aug 4, 2025
• Publicly Available Date: Aug 4, 2025
• DOI: https://doi.org/10.48526/rgu-wt-2807345
• Public URL: https://rgu-repository.worktribe.com/output/2807345
• Award Date: Dec 31, 1995