ปัญหาการใช้ยาที่บ้านของผู้ป่วยสูงอายุในเขตอำเภอลอง / จุฬาลักษณ์ จงวิริยานุรักษ์ = Drug related problems in geriatric patients at home in Long District / Chulalak Chongwiriyanurak
Drug related problems in geriatric patients at home was studied after discharge from Long Hospital, Phrae. Pharmacist visited at their home 4 times during November 1998 to May 1999. This was done on 54 patients. The objectives of this study were to examine the types of problems, rate of occurrence, causes of problem and readmission rate. At the first home visit, 75 drug related problems (DRPs) were found in 40 cases (74.1%), mean of DRPs was 1.39 per patient. The twenty-two patients (81.5%) who used drugs by themselves had DRPs more than patients who had care giver. The number of DRPs in the first group was significantly more than the other group (p<0.05). The numbers of problems and patients were decreased when the pharmacist visited at home the second, the third and the fourth time. There was 4 DRPs in 3 patients at the last visited. The number of DRPs after these services was significantly lower than those of before the service rendered (P<0.05). The result showed that the most encountered problem was failure to receive prescribed drug (109 problems) because the patients did not understand the instructions. The second rank was adverse drug reactions (10 problems). Twenty patients (37.0%) were readmitted during the seven months period of this study. The causes of readmission could not be proven, however the number of patients who admitted more than 2 times were reduced from 4 patients before the study to 1 patient at the end of the study. The home visit by the pharmacist reduced the number of drug related problems by increasing the cooperation about drug usage, decreasing adverse drug reactions and increasing knowledge about their medicines. When the pharmacist visited patients at home, she encountered the patients' lifestyle and environment and could find the problems that may be ignored when they were in the hospital such as how to keep the medications. The patients agreed that pharmacist home visit was mostly beneficial to them.
