Drug-related problems and factors influencing acceptance of clinical pharmacologists’ alerts in a large cohort of neurology inpatients
QUESTIONS UNDER STUDY/PRINCIPLES: Data regarding the prevalence and types of drug-related problems (DRPs) among neurology inpatients is sparse. The objective of this study was to characterise the types of DRPs seen among neurology inpatients and furthermore to study factors affecting the accep...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2012-07-01
|
| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1516 |
| _version_ | 1826995836606742528 |
|---|---|
| author | Anne B Taegtmeyer Ivanka Curkovic Natascia Corti Christoph Rosen Marco Egbring Stefan Russmann Andreas R Gantenbein Michael Weller Gerd A Kullak-Ublick |
| author_facet | Anne B Taegtmeyer Ivanka Curkovic Natascia Corti Christoph Rosen Marco Egbring Stefan Russmann Andreas R Gantenbein Michael Weller Gerd A Kullak-Ublick |
| author_sort | Anne B Taegtmeyer |
| collection | DOAJ |
| description |
QUESTIONS UNDER STUDY/PRINCIPLES: Data regarding the prevalence and types of drug-related problems (DRPs) among neurology inpatients is sparse. The objective of this study was to characterise the types of DRPs seen among neurology inpatients and furthermore to study factors affecting the acceptance of clinical pharmacologists’ and pharmacists’ recommendations for improving drug safety.
METHODS: 1,263 consecutive inpatient cases in a Swiss university hospital neurology unit were assessed for the presence of DRPs over 12 months. Treating neurologists’ acceptance of the resulting recommendations was also recorded. Primary outcome measures were types of DRP, recommendations made by clinical pharmacologists and number of recommendations accepted. Factors potentially associated with acceptance were studied using univariate and multivariate generalised estimating equation modelling.
RESULTS: Twenty-nine percent of cases demonstrated one or more DRPs. DRPs were the cause of admission in 10 cases (0.8%). In total 494 DRPs were identified and 467 recommendations given, of which 62% were accepted. Factors associated with an increased likelihood of acceptance were prescriptions involving regularly administered drugs (odds ratio [OR] 2.57 95% confidence interval [CI] 1.73–3.80), adverse drug events (OR 2.5; 95% CI 1.29–5.06), known drug side-effect (OR 1.85; 95% CI 1.06–3.22), high-risk drug-drug interactions (OR 3.22; 95% CI 1.07–9.69) and interventions involving changing a drug (OR 2.71; 95% CI 1.17–6.25).
CONCLUSION: Clinical pharmacologists and pharmacists can play an important role in identifying DRPs among neurology inpatients. Their recommendations for optimising medication-safety are most likely to be accepted for regular prescriptions, prescriptions associated with an adverse drug event and high-risk drug combinations.
|
| first_indexed | 2024-04-13T03:50:04Z |
| format | Article |
| id | doaj.art-70ccbd4bc8fd492d8908822762640e4f |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2025-02-18T09:38:04Z |
| publishDate | 2012-07-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-70ccbd4bc8fd492d8908822762640e4f2024-11-02T17:27:02ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972012-07-01142272810.4414/smw.2012.13615Drug-related problems and factors influencing acceptance of clinical pharmacologists’ alerts in a large cohort of neurology inpatientsAnne B TaegtmeyerIvanka CurkovicNatascia CortiChristoph RosenMarco EgbringStefan RussmannAndreas R GantenbeinMichael WellerGerd A Kullak-Ublick QUESTIONS UNDER STUDY/PRINCIPLES: Data regarding the prevalence and types of drug-related problems (DRPs) among neurology inpatients is sparse. The objective of this study was to characterise the types of DRPs seen among neurology inpatients and furthermore to study factors affecting the acceptance of clinical pharmacologists’ and pharmacists’ recommendations for improving drug safety. METHODS: 1,263 consecutive inpatient cases in a Swiss university hospital neurology unit were assessed for the presence of DRPs over 12 months. Treating neurologists’ acceptance of the resulting recommendations was also recorded. Primary outcome measures were types of DRP, recommendations made by clinical pharmacologists and number of recommendations accepted. Factors potentially associated with acceptance were studied using univariate and multivariate generalised estimating equation modelling. RESULTS: Twenty-nine percent of cases demonstrated one or more DRPs. DRPs were the cause of admission in 10 cases (0.8%). In total 494 DRPs were identified and 467 recommendations given, of which 62% were accepted. Factors associated with an increased likelihood of acceptance were prescriptions involving regularly administered drugs (odds ratio [OR] 2.57 95% confidence interval [CI] 1.73–3.80), adverse drug events (OR 2.5; 95% CI 1.29–5.06), known drug side-effect (OR 1.85; 95% CI 1.06–3.22), high-risk drug-drug interactions (OR 3.22; 95% CI 1.07–9.69) and interventions involving changing a drug (OR 2.71; 95% CI 1.17–6.25). CONCLUSION: Clinical pharmacologists and pharmacists can play an important role in identifying DRPs among neurology inpatients. Their recommendations for optimising medication-safety are most likely to be accepted for regular prescriptions, prescriptions associated with an adverse drug event and high-risk drug combinations. https://www.smw.ch/index.php/smw/article/view/1516acceptanceclinical pharmacologyclinical pharmacydrug-related problemsdrug-safetyneurology |
| spellingShingle | Anne B Taegtmeyer Ivanka Curkovic Natascia Corti Christoph Rosen Marco Egbring Stefan Russmann Andreas R Gantenbein Michael Weller Gerd A Kullak-Ublick Drug-related problems and factors influencing acceptance of clinical pharmacologists’ alerts in a large cohort of neurology inpatients Swiss Medical Weekly acceptance clinical pharmacology clinical pharmacy drug-related problems drug-safety neurology |
| title | Drug-related problems and factors influencing acceptance of clinical pharmacologists’ alerts in a large cohort of neurology inpatients |
| title_full | Drug-related problems and factors influencing acceptance of clinical pharmacologists’ alerts in a large cohort of neurology inpatients |
| title_fullStr | Drug-related problems and factors influencing acceptance of clinical pharmacologists’ alerts in a large cohort of neurology inpatients |
| title_full_unstemmed | Drug-related problems and factors influencing acceptance of clinical pharmacologists’ alerts in a large cohort of neurology inpatients |
| title_short | Drug-related problems and factors influencing acceptance of clinical pharmacologists’ alerts in a large cohort of neurology inpatients |
| title_sort | drug related problems and factors influencing acceptance of clinical pharmacologists alerts in a large cohort of neurology inpatients |
| topic | acceptance clinical pharmacology clinical pharmacy drug-related problems drug-safety neurology |
| url | https://www.smw.ch/index.php/smw/article/view/1516 |
| work_keys_str_mv | AT annebtaegtmeyer drugrelatedproblemsandfactorsinfluencingacceptanceofclinicalpharmacologistsalertsinalargecohortofneurologyinpatients AT ivankacurkovic drugrelatedproblemsandfactorsinfluencingacceptanceofclinicalpharmacologistsalertsinalargecohortofneurologyinpatients AT natasciacorti drugrelatedproblemsandfactorsinfluencingacceptanceofclinicalpharmacologistsalertsinalargecohortofneurologyinpatients AT christophrosen drugrelatedproblemsandfactorsinfluencingacceptanceofclinicalpharmacologistsalertsinalargecohortofneurologyinpatients AT marcoegbring drugrelatedproblemsandfactorsinfluencingacceptanceofclinicalpharmacologistsalertsinalargecohortofneurologyinpatients AT stefanrussmann drugrelatedproblemsandfactorsinfluencingacceptanceofclinicalpharmacologistsalertsinalargecohortofneurologyinpatients AT andreasrgantenbein drugrelatedproblemsandfactorsinfluencingacceptanceofclinicalpharmacologistsalertsinalargecohortofneurologyinpatients AT michaelweller drugrelatedproblemsandfactorsinfluencingacceptanceofclinicalpharmacologistsalertsinalargecohortofneurologyinpatients AT gerdakullakublick drugrelatedproblemsandfactorsinfluencingacceptanceofclinicalpharmacologistsalertsinalargecohortofneurologyinpatients |