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Background <p>Drug-related problems (DRPs) are prevalent in geriatric patients and associated with poor health outcomes. Clinical pharmacists (CPs) play a key role in optimising medication use, yet the benefits of CP interventions in collaboration with the geriatrician in a geriatric day hospital setting remain underexplored.</p> Aim <p>This study aimed to: (1) evaluate CP activities at a geriatric day hospital by analysing (a) identified DRPs and recommendations, and (b) the prevalence of potentially inappropriate medications (PIMs), including Fall-Risk Increasing Drugs (FRIDs), at admission/discharge; and (2) examine the acceptance and implementation rates of CPs’ recommendations by the attending geriatrician.</p> Method <p>All patients that visited the day hospital during 25 non-consecutive days were invited to participate. DRPs and corresponding CPs’ recommendations were categorised and analysed. PIMs were identified retrospectively using the Ghent Older People’s Prescriptions community Pharmacy Screening-tool version 2.</p> Results <p>Ninety-nine patients were included (median age: 85&#xa0;years, 72.7% female). The most frequently identified DRP was ‘no indication’. Drugs used for the nervous system were mostly involved. CPs proposed 251 recommendations (median: two per patient), which most frequently concerned ‘stop therapy’. The acceptance rate was 80.1%, of which 73.1% were implemented immediately. The PIM prevalence decreased from 91.8% on admission to 87.6% at discharge (<i>p</i> &lt; .001). The median number of FRIDs was two at both timepoints.</p> Conclusion <p>CPs can have a valuable role in the interdisciplinary team at a geriatric day hospital. Regularly reevaluating the appropriate use of drugs used for the nervous system, and initiating judicious deprescribing is recommended.</p>

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Evaluating an integrated clinical pharmacist model in a geriatric day hospital: a prospective single-centre observational study

  • 期刊论文

  • 发表日期：

    2025年6月4日

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  • Ine Simal,
  • Andreas Capiau,
  • Anton De Spiegeleer,
  • Anja Velghe,
  • Nele Van Den Noortgate,
  • Mirko Petrovic,
  • Annemie Somers

摘要

Background

Drug-related problems (DRPs) are prevalent in geriatric patients and associated with poor health outcomes. Clinical pharmacists (CPs) play a key role in optimising medication use, yet the benefits of CP interventions in collaboration with the geriatrician in a geriatric day hospital setting remain underexplored.

Aim

This study aimed to: (1) evaluate CP activities at a geriatric day hospital by analysing (a) identified DRPs and recommendations, and (b) the prevalence of potentially inappropriate medications (PIMs), including Fall-Risk Increasing Drugs (FRIDs), at admission/discharge; and (2) examine the acceptance and implementation rates of CPs’ recommendations by the attending geriatrician.

Method

All patients that visited the day hospital during 25 non-consecutive days were invited to participate. DRPs and corresponding CPs’ recommendations were categorised and analysed. PIMs were identified retrospectively using the Ghent Older People’s Prescriptions community Pharmacy Screening-tool version 2.

Results

Ninety-nine patients were included (median age: 85 years, 72.7% female). The most frequently identified DRP was ‘no indication’. Drugs used for the nervous system were mostly involved. CPs proposed 251 recommendations (median: two per patient), which most frequently concerned ‘stop therapy’. The acceptance rate was 80.1%, of which 73.1% were implemented immediately. The PIM prevalence decreased from 91.8% on admission to 87.6% at discharge (p < .001). The median number of FRIDs was two at both timepoints.

Conclusion

CPs can have a valuable role in the interdisciplinary team at a geriatric day hospital. Regularly reevaluating the appropriate use of drugs used for the nervous system, and initiating judicious deprescribing is recommended.