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MEDICATION SAFETY

Comparison of Drug-Related Problems in Different Patient Groups

Specialist in Hospital Pharmacy, Head, Department of Clinical Pharmacy, Diakonhjemmet Hospital Pharmacy, Oslo, Norway

Hege S Blix, MSc

Specialist in Hospital Pharmacy, Head, Department of Clinical Pharmacy, Lovisenberg Diakonale Hospital, Oslo

Aasmund Reikvam, MD PhD

Professor, Fellow of the European Society of Cardiology, Department of Pharmacotherapy, Faculty of Medicine, University of Oslo

Tron A Moger, MSc

Research Fellow, Department of Medical Statistics, University of Oslo

Bodil J Hjemaas, MSc

Hospital Pharmacist, Diakonhjemmet Hospital Pharmacy

Elspeth K Walseth, MSc

Hospital Pharmacist, Diakonhjemmet Hospital Pharmacy

Tine F Vraalsen, BSc

Hospital Pharmacist, Ullevaal Pharmacy, Oslo

Piia Pretsch, MSc

Hospital Pharmacist, Aker Hospital Pharmacy, Oslo

Frank Jorgensen, MSc

Specialist in Hospital Pharmacy, Haukeland Hospital Pharmacy, Bergen, Norway

Reprints: Kirsten K Viktil MSc, Diakonhjemmet Hospital Pharmacy, Box 23 Vinderen, NO-0319 Oslo, Norway, fax 47 22 45 17 69, kiviktil{at}online.no

BACKGROUND: There is a lack of knowledge concerning how drug-related problems (DRPs) vary in different patient groups. Possible dissimilarities need to be taken into consideration when guidelines for detecting and preventing DRPs are compiled.

OBJECTIVE: To characterize and compare the frequency and categories of DRPs in different groups of hospitalized patients.

METHODS: Patients admitted to 4 different types of departments at 5 hospitals in Norway were included consecutively. Medical records and information acquired at multidisciplinary morning meetings were sources for assessing the patients' DRPs.

RESULTS: A total of 827 patients were included. Mean age was 70.8 years, 58.6% were female, and 81% had at least one DRP. An average of 1.9, 2.0, 2.1, and 2.3 DRPs per patient were found in the departments of cardiology, geriatrics, respiratory medicine, and rheumatology, respectively. Significant differences in the type of DRPs between the patient groups were found. The most frequent DRPs and the patient group in which they most often occurred were nonoptimal dose (cardiology, respiratory, geriatric) and need for additional drug (rheumatology).

CONCLUSIONS: DRPs occurred in the majority of the patients in all departments. The type of DRP differed markedly between the patient groups. Knowledge of these differences is clinically valuable by enabling us to guide efforts toward prevention of DRPs. Antithrombotic agents, loop diuretics, angiotensin-converting enzyme inhibitors, penicillins, antiinflammatory drugs, and opioid analgesics commonly caused DRPs, even in departments where knowledge of these drugs is assumed to be extensive.

Key Words: comparison of DRPs, drug-related problems, hospitalized patients

Published Online, April 6, 2004. www.theannals.com, DOI 10.1345/aph.1D531

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