External validation of the Medication Risk Score in polypharmacy patients in general practice: A tool for prioritizing patients at greatest risk of potential drug-related problems.

Tytuł:: External validation of the Medication Risk Score in polypharmacy patients in general practice: A tool for prioritizing patients at greatest risk of potential drug-related problems.
Autorzy:: Høj K; Research Unit for General Practice, Aarhus, Denmark.; Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
Pedersen HS; Research Unit for General Practice, Aarhus, Denmark.
Lundberg ASB; Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.
Bro F; Research Unit for General Practice, Aarhus, Denmark.; Department of Public Health, Aarhus University, Aarhus, Denmark.
Nielsen LP; Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
Saedder EA; Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus, Denmark.; Department of Biomedicine, Aarhus University, Aarhus, Denmark.
Źródło:: Basic & clinical pharmacology & toxicology [Basic Clin Pharmacol Toxicol] 2021 Oct; Vol. 129 (4), pp. 319-331. Date of Electronic Publication: 2021 Jul 14.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: <2005-> : Oxford : Blackwell
Original Publication: Copenhagen, Denmark : Oxford, UK : Nordic Pharmacological Society Distributed by Blackwell Munksgaard, 2004-
MeSH Terms:: Drug-Related Side Effects and Adverse Reactions/*epidemiology
Drug-Related Side Effects and Adverse Reactions/*prevention & control
Aged ; Cross-Sectional Studies ; Denmark/epidemiology ; Female ; General Practice ; Humans ; Inappropriate Prescribing/prevention & control ; Male ; Medication Errors ; Medication Review ; Medication Therapy Management ; Middle Aged ; Polypharmacy ; Risk Factors
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Grant Information:: Central Denmark Region; Research Unit for General Practice, Aarhus; Aarhus University Hospital, Department of Clinical Pharmacology
Contributed Indexing:: Keywords: drug-related problems; general practice; medication errors; polypharmacy; risk assessment; validation study
Entry Date(s):: Date Created: 20210708 Date Completed: 20220110 Latest Revision: 20220110
Update Code:: 20240105
DOI:: 10.1111/bcpt.13636
PMID:: 34237199
: Czasopismo naukowe

Pełny tekst

Drug-related problems are important causes of patient harm and increased healthcare costs. To assist general practitioners in prioritizing patients in need of a critical medication review, we aimed to assess the ability of the Medication Risk Score (MERIS) to stratify patients with polypharmacy in general practice according to their risk of drug-related problems. We conducted a cross-sectional multi-centre external validation study. Patients receiving more than five concomitant medications (polypharmacy) were eligible. The outcome was potentially serious drug-related problems as evaluated by expert consensus. Performance was assessed in terms of calibration and discrimination indices. Of 497 patients, 489 were included in the main analysis. The median age (interquartile range) was 70.5 years (60-79). In total, 372 potentially serious drug-related problems were observed in 253 patients (52%). The MERIS was well calibrated above a score level of 10. The area under the receiver operating characteristic curve was 0.70 (95% confidence interval: 0.65-0.74). The performance of the MERIS was fair in patients with polypharmacy in general practice. Given the scale of drug-related problems and the lack of efficient prioritization tools in this setting, the MERIS could be a useful risk indicator to complement usual practice.
(© 2021 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).)

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