10 - Drug-Related Problems Flashcards
_Describe trends in prescription (Rx)
and over the counter (OTC) medication use in the US_
2000 –> 2012
8% –> 15%
of people taking 5 or more RX drugs
nearly DOUBLED
INCREASING USE OF PRESCRIPTION DRUGS
59% of adults taking Rx drugs // 4.1 RX drugs per person
74.2%ofDr. Visits –> drugs
4.02 billion prescriptions written in the U.S. in 2011
$325.7 billion spent on Rx drugs in 2012
VS
81% of adults use OTC meds as first response to minor ailments
- *338$ / Year** is the average US households spend on OTC’s
- *34$ billion in sales**
•Define drug-related problems (DRPs)
An event or circumstance involving a patient’s drug treatment that actually, or potentially interferes with the
achievement of an optimal outcome.
•List and differentiate types of DRPs
Indication
Unnecessary Drug Therapy
Requires Additional Drug Therapy
Effectiveness
- *Ineffective drug**
- *Dosage TOO LOW**
Safety
ADR + dosage TOO HIGH
Adherence
Non-adherence / Noncompliance
_•Identify causes and associated costs of drug-related
morbidity and mortality_
result from failure of therapeutic agent to produce
the intended therapeutic outcome
(includes treatment failure and production of new medical problems)
Causes = Inappropriate:
Prescribing / Drug Delivery / Monitoring / Patient Behavior
Patient idiosyncrasy
Costs
1995 –> $76.6 Billion in the amb-setting alone
2000 –> $177 billion in amb care
largest component of DR-Hospitilizations
Describe the role of the pharmacist in preventing DRP
Pharmacists are key players in
preventing drug-related morbidity and mortality, improving outcomes, and reducing costs of care.
•The profession of pharmacy must endeavor to help
transform the existing processes into a drug use system to
promote rational drug therapy
•Pharmaceutical Care, Medication-Therapy-Management, Patient-Centered-Care, Pharmacists’ Patient Care Process
What type of DRP?
•Untreated condition
•Preventative / prophylactic
•Synergistic / potentiating
Requires ADDITIONAL Drug Therapy
INDICATION
What type of DRP?
•No medical indication
- Duplicate therapy
- Non-drug therapy indicated
- Treating avoidable ADR
Un-necessary Drug Therapy
INDICATION
What type of DRP?
•More effective drug available
•Condition refractory to drug
•Dosage form inappropriate
•Not effective for condition
Requires DIFFERENT Drug Product
EFFECTIVENESS
What type of DRP?
•Wrong dose
•Frequency inappropriate
•Duration inappropriate
•Drug interaction
Dosage TOO LOW
Effectiveness
What type of DRP?
•Undesirable effect
•Unsafe drug for patient
•Dose changed too quickly
•Allergic reaction
•Contraindications present
ADVERSE DRUG REACTION
SAFETY
What type of DRP?
•Wrong dose
•Frequency inappropriate
•Incorrect administration
•Drug interaction
DOSE TOO HIGH
SAFETY
same as DOSE TOO LOW
for effectiveness
What DRP?
•Directions not understood
- Patient prefers not to take
- Patient forgets to take
- Drug product too expensive
- Cannot swallow/administer
•Drug product not available
NON-ADHERENCE
Adherence
ADEs
Adverse Drug Events
include BOTH
Preventable = medication errors
&
un-avoidable events = ADR
