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Drug-Related Problems Identified at Patients' Home: A Prospective Observational Study in a Rural Area of Thailand

Kongkaew, Chuenjid PhD*; Methaneethorn, Janthima PhD*; Mongkhon, Pajaree PharmD*†; Dechanont, Supinya PharmD*; Taburee, Watcharaporn MD

doi: 10.1097/PTS.0000000000000404
Original Article: PDF Only

Objective The aim of the study was to examine the prevalence rates, nature, and predictors of drug-related problems (DRPs) experienced in participants living at home in a rural Thailand.

Method A cross-sectional observational study was undertaken during December 2015 to January 2016. Drug-related problems were identified within a rural township having a population of 5256 by means of home visits by pharmacists. All suspected cases were then assessed for severity and preventability by clinical specialists. Drug-related problems were categorized according to Pharmaceutical Care Network Europe classification (revised 2010).v.6.2

Results From a systematically recruited cohort of 359 participants, suspected DRPs were identified in 160 participants. After detailed reviews by clinical specialists, 141 cases (39.3%) were deemed to have DRPs. Types of DRPs with prevalence rates were the following: problems of treatment effectiveness (3.7% of DPRs), adverse reactions (15.3%), treatment cost (28.4%), nonadherence to drugs (42.1%), and poor drug storage (10.5%). The most common drug to involve DRPs was those treating cardiovascular disease, especially simvastatin.

Conclusions Nearly half of community living participants experienced DRPs, especially nonadherence to drugs, and has implications for other rural elderly persons of low education attainment for similar rural economies around the globe. Appropriate interventions should focus on reducing polypharmacy, providing outreach programs, and rigorous pharmacovigilance.

From the *Center for Safety and Quality in Health, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok; † School of Pharmaceutical Sciences, University of Phayao, Phayao; and ‡Department of Family medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand.

Correspondence: Chuenjid Kongkaew, PhD, Department of pharmacy practice, Faculty of Pharmaceutical Sciences, Naresuan University, 99 Moo 9, Phitsanulok-Nakhon Sawan Road, Tha Pho, Mueang Phitsanulok, Phitsanulok 65000, Thailand (e-mail: chuenjid@googlemail.com).

The authors disclose no conflict of interest.

This study was supported by Thai Health Promotion Foundation, Thailand. The funder had no role in the design and conduct of the study; data collection, management, analysis and interpretation, as well as article preparation, review, or approval of the article.

C.K. conceived, designed, and supervised the study. P.M., J.M., and C.K. performed data acquisition, data analysis, and data interpretation; W.T. and S.D. extensively reviewed suspected DRPs. J.M. and C.K. drafted the article. C.K. critically reviewed and revised the article. All authors read and approved the final article.

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