Drug-Related Problems (DRPs) | Control (n = 223) | Control 1 month after discharge (n = 178) | Intervention (n = 223) | Intervention 1 month after discharge (n = 99) |
---|---|---|---|---|
Part 1: potentially inappropriate drugs, independent of diagnosis | ||||
 Opioids | 30 (14.9) | 18 (10.1) | 21 (9.4) | 12 (12.1) |
 PPIa >8 weeks | 19 (9.4) | 22 (12.3) | 32 (14.3) | 14 (14.1) |
 Benzodiazepines or Z-drugs | 18 (9.0) | 25 (14.0) | 21 (9.4) | 16 (16.2) |
 Acetylsalicylic acid > 100 mg/day | 16 (8.0) | 3 (1.7) | 10 (4.5) | 0 (0) |
 Antidepressants > 1 year | 6 (3.0) | 7 (3.9) | 8 (3.6) | 2 (2.0) |
 Systemic NSAIDsb | 3 (1.5) | 5 (2.8) | 6 (2.7) | 1 (1.0) |
 Centrally-acting antihypertensives | 2 (1.0) | 2 (1.1) | 2 (0.9) | 1 (1.0) |
 Alizapride | 2 (1.0) | 0 (0) | 0 (0) | 0 (0) |
 Antipsychotics > 1 month | 1 (0.5) | 1 (0.6) | 5 (2.2) | 4 (4.0) |
 Contact laxatives for daily use > 2 weeks | 1 (0.5) | 2 (1.1) | 5 (2.2) | 3 (3.0) |
 Metoclopramide | 1 (0.5) | 1 (0.6) | 1 (0.4) | 0 (0) |
 Barbiturates | 1 (0.5) | 1 (0.6) | 0 (0) | 0 (0) |
 Oral decongestants | 1 (0.5) | 2 (1.1) | 0 (0) | 0 (0) |
 Long-acting sulphonylurea derivatives | 0 (0) | 0 (0) | 1 (0.4) | 0 (0) |
 Narcotic antitussives | 0 (0) | 2 (1.1) | 0 (0) | 0 (0) |
 Sedating antihistaminic | 0 (0) | 1 (0.6) | 0 (0) | 0 (0) |
Part 2: potentially inappropriate drugs, dependent of diagnosis | ||||
 Drugs likely to cause constipation in patients with known constipation | 14 (6.9) | 11 (6.2) | 15 (6.7) | 6 (6.1) |
 Drugs with anticholinergic properties with known dementia/cognitive impairment | 6 (3.0) | 6 (3.4) | 4 (1.8) | 2 (2.0) |
 Systemic predniso(lo)ne-equivalents > 7.5 mg/day with diabetes | 1 (0.5) | 1 (0.6) | 1 (0.4) | 1 (1.0) |
 Drugs with anticholinergic properties with known benign prostatic hyperplasia | 1 (0.5) | 1 (0.6) | 1 (0.4) | 0 (0) |
Part 3: Potentially omitted medication in older people | ||||
 Opioids without laxative | 18 (8.9) | 8 (4.5) | 8 (3.6) | 0 (0) |
 Osteoporotic therapy without adequate calcium/vitamin D | 6 (3.0) | 4 (2.2) | 4 (1.8) | 1 (1.0) |
 Predniso(lo)ne-equivalent of ≥ 7.5 mg for ≥ 3 months without calcium/vitamin D supplementation and bisphosphonate | 2 (1.0) | 1 (0.6) | 1 (0.4) | 0 (0) |
Part 4: Drug-Drug interactions of specific relevance | ||||
 Combination of FRIDs | 29 (14.4) | 29 (16.3) | 35 (15.7) | 21 (21.2) |
 Combination of drugs with anticholinergic properties | 8 (4.0) | 7 (3.9) | 17 (7.6) | 11 (11.1) |
 Combination of QT prolonging drugs or combination of QT prolonging drug and drug that inhibits metabolism of this drug | 6 (3.0) | 5 (2.8) | 13 (5.8) | 4 (4.0) |
 Combination of drugs leading to increased bleeding risk | 5 (2.5) | 7 (3.9) | 5 (2.2) | 0 (0) |
 RAASc inhibitor + potassium sparing diuretic/potassium supplement/potassium containing drug | 1 (0.5) | 1 (0.6) | 4 (1.8) | 0 (0) |
 Systemic NSAID + RAAS inhibitor | 1 (0.5) | 3 (1.7) | 3 (1.3) | 0 (0) |
 Oral antidiabetics with risk of hypoglycaemia/insulin + non-selective β-blocker | 1 (0.5) | 1 (0.6) | 0 (0) | 0 (0) |
 Systemic NSAID + Diuretic | 1 (0.5) | 1 (0.6) | 0 (0) | 0 (0) |