Detection and Origins of Geriatric Drug-Related Hospitalizations. Final Narrative Progress Report

摘要

The investigators (1) developed a protocol for identifying and characterizing geriatric drug-related hospital admissions (DRA protocol); (2) refined and validated an instrument for assessing appropriateness of physician prescribing; and (3) attempted to validate a compliance instrument. Inter-rater reliability among two clinical pharmacists and a physician was tested for the DRA protocol. In 85% of cases, at least two reviewers agreed on the type of drug problem that led to admission. Patients' self-reported compliance with drug regimens was not validated by pharmacy records. The study produced: (1) a valid instrument for detecting and characterizing geriatric drug-related hospital admissions, and (2) a refined and valid instrument for assessing the appropriateness of physician prescribing practices. Assessment of hospitalizations found that 20% of 242 patients had problems due to and omitted-but-necessary therapy and 15% due to underdosage. Moreover, drug problems contributed to the admissions of 53% of patients, including 12% due to omitted therapies.