Aim: The previous studies on factors of the residual medicines were conducted only through the patients with residual medicines. The aim of this study is to clarify the factors that lead to residual medicine by comparing between groups of patients with and without residual medicines.
Methods: Patients for this study were supported, during study period between April 2016 and March 2018, with a residual medicine protocol, which allowed pharmacists at health insurance pharmacies to decide whether to change the number of prescription days based on the amount of residual medicines. Group of patients without residual medicines (full medicine use group) and group of patients with residual medicines (residual medicine group) were compared. Comparison items were sex, age, hospital department, number of prescribed drugs, number of days per prescription, and classification of drugs by efficacy.
Results: The number of the patients of the full medicine use group was 19,746, and that of the residual medicine group was 1,851. Average ages of two groups were 61.0 and 70.0. Median numbers of prescribed medicines were 2.0 and 4.3, median numbers of days per prescription were 28.0 and 56.0. Percentage of hospital departments visited by patients was high in the rheumatology and the endocrinology in the residual medicine group, and lower in pediatrics. Antidiabetic agents tended to be prescribed more in the residual medicine group.
Conclusion: It might be concluded that old age, having many prescribed drugs, longer prescription durations, and prescriptions for chronic diseases were important factors of residual medicine.
Aim: To examine the case in which somnolence has been alleviated as a result of pharmacist’s intervention with residents of special nursing home receiving polypharmacy.
Methods: The case was extracted from the subjects who had been enrolled in an interventional study conducted by the authors. Information was collected based on records of the pharmacist’s intervention, and analyzed to identify the reasons the interventions were successful.
Results: The patient was a female who had been prescribed a drug classified as a potentially inappropriate medication (PIM) according to STOPP-J. In the case, Risperidone was reduced the dose. The resident’s improved somnolence and tremors during the day resulting in the resident’s activity level and Quality of Life (QOL).
Conclusion: The factors that contributed to alleviating the patients’ somnolence were (1) the adverse events were associated with PIMs and the prescriptions were modified, (2) the pharmacists shared information with other medical professionals, and (3) the pharmacists gave the patients individualized attention and monitoring, in collaboration with other medical professionals in a multidisciplinary approach.
Aim: In a previous study, we reported on the relationship between gait speed and the number of medications and prescription content. Elderly people frequently complain of dry skin. Therefore, to screen elderly patients with dry skin according to prescription content, we investigated the effects of prescription content on stratum corneum moisture content and body mass index (BMI), which is an indicator of body weight.
Methods: A total of 31 patients over 65 years of age taking five or more medications were enrolled. The stratum corneum moisture content, BMI, and prescription content were evaluated.
Results: The subjects were classified into a laxative medication group and a non-medication group. The stratum corneum moisture content and BMI were significantly lower in the medication group than in the non-medication group. These results suggest that elderly people who take medicated laxatives experience a significant decrease in stratum corneum water content and may develop dry skin.
Conclusions: It was considered necessary to pay attention not only to the number of medications but also to the prescription content.
Polypharmacy is common among older adults with multiple chronic comorbidities and has been associated with adverse outcomes. This study aimed to investigate the clarify an efficient approach to eliminate polypharmacy. The primary endpoint was a multivariate logistic regression analysis that was performed to compare the effects of each factor in the polypharmacy and non-polypharmacy groups. The secondary endpoint was the relation between the period until the unscheduled visit within three months, measured by Cox proportional hazards model. In the multivariate analysis, the number of diseases (odds ratio = 1.01; P = 0.04) and more. Cox proportional hazards model was performed on the factors related to the unscheduled visit, and a significant difference was found in the relation with drug-drug interaction (hazard ratio = 1.51; P = 0.03) and more. The results of this study suggest the possibility of more efficiently leading to the correction of polypharmacy.