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Effect of Pharmacist Intervention on a Population in Taiwan with High Healthcare Utilization and Excessive Polypharmacy

Author

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  • Tzu-Chueh Wang

    (Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan)

  • Damien Trezise

    (Department of Applied Foreign Language, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan)

  • Pou-Jen Ku

    (Taiwan Pharmacist Association, Taipei City 10452, Taiwan)

  • Hai-Lin Lu

    (Department of Information Management, Chia Nan University of Pharmacy and Science, Tainan City 71710, Taiwan)

  • Kung-Chuan Hsu

    (Giraffe Pharmacy, Tainan City 71049, Taiwan)

  • Po-Cheng Hsu

    (Yong-xiang Pharmacy, Tainan City 70059, Taiwan)

Abstract

Patients with high healthcare utilization are at increased risk of polypharmacy and drug interactions. This study investigated the changes in the number of medications, drug interactions and interaction severity in high frequency outpatients with polypharmacy at hospitals and clinics in Taiwan after home pharmaceutical care, to understand the effectiveness of interventions by pharmacists. This was a retrospective observational study. Cases with excessive polypharmacy (10+ drugs) were selected from the Pharmaceutical Care Practice System database of the Taiwan Pharmacist Association in 2017. After the home care intervention, the number of drug types used decreased 1.89-fold ( p < 0.001), and the number of medications fell 61.6%. The incidence of drug interaction was 93.82%. In an average case, the incidence of drug interaction after the pharmacist intervention decreased 0.6-fold ( p < 0.001). The drug most commonly causing interactions was aspirin, followed by diclofenac; also common were three used in diabetes, two psycholeptics and two beta blockers. Among 22 cases of severe drug interaction, seven resulted in increased risk of extrapyramidal symptoms and neuroleptic malignant syndrome. By analyzing the relationship between the side effects of individual drugs and the pharmacokinetic T max , a sequential thermal zone model of adverse drug reactions can be established, the value of which could prompt physicians and pharmacists to intervene in order to prevent adverse events. It is concluded that home pharmaceutical care by pharmacists can significantly reduce the number of medications and interactions in patients with excessive polypharmacy and high healthcare utilization.

Suggested Citation

  • Tzu-Chueh Wang & Damien Trezise & Pou-Jen Ku & Hai-Lin Lu & Kung-Chuan Hsu & Po-Cheng Hsu, 2019. "Effect of Pharmacist Intervention on a Population in Taiwan with High Healthcare Utilization and Excessive Polypharmacy," IJERPH, MDPI, vol. 16(12), pages 1-9, June.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:12:p:2208-:d:242073
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    Citations

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    Cited by:

    1. Chien-Ying Lee & Heng-Hsuan Su & Yu-Chia Chang & Tung-Han Tsai & Yung-Rung Lai & Kuang-Hua Huang, 2021. "The Impact of Pharmaceutical Home Care on Medical Utilization for Frequent Users of Outpatient Services in Taiwan," IJERPH, MDPI, vol. 18(14), pages 1-12, July.
    2. Kung-Chuan Hsu & Hai-Lin Lu & Chi-Ming Kuan & Jin-Song Wu & Chyn-Liang Huang & Pu-Hua Lin & Damien Trezise & Tzu-Chueh Wang, 2021. "Potentially Inappropriate Medication among Older Patients Who Are Frequent Users of Outpatient Services," IJERPH, MDPI, vol. 18(3), pages 1-11, January.
    3. Teen-Hang Meen & Yusuke Matsumoto & Kuei-Shu Hsu, 2020. "Selected Papers from 2019 IEEE Eurasia Conference on Biomedical Engineering, Healthcare and Sustainability (IEEE ECBIOS 2019)," IJERPH, MDPI, vol. 17(8), pages 1-4, April.

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