DOI: 10.36347/sjams.2019.v07i01.057

Pages: 312-322

Background: Drug-related problems (DRPs) are risk factors for preventable hospital admissions/readmissions, especially in elderly. Studies have reported the prevalence and types of DRPs in Singapore/Asian elderly, but did not classify them based on preventability, which determines the possibility of avoiding these DRPs. Literature on ways policymakers can tackle DRPs, including collaborations with and interventions by community pharmacists, and local/Asian data on resulting cost savings, is also limited. Additionally, the scarcity of economic data supporting the role of these actions restricts evaluation of their cost-effectiveness. Objective: This study aims to identify, categorize and quantify preventable DRPs present among hospital admissions, estimating associated healthcare costs. Methods: This cross-sectional study was conducted among patients admitted into Alexandra Hospital from October to December 2017. DRPs were categorised using Pharmaceutical Care Network Europe DRP classification version 8.02, then further classified as preventable, non-preventable or potentially preventable based on pre-defined criteria. Hospitalization cost was estimated using published average bill sizes from Singapore’s Ministry of Health. Results: Out of 379 hospitalizations, 145 (38.3%) had one or more DRPs with 90.3% (131/145) being preventable. Most DRPs were related to pharmacotherapy non-compliance, followed by unnecessary drug therapy and adverse drug reactions. Median cost per admission was higher in hospitalizations with non-preventable DRPs on admission than those with preventable DRPs on admission, though not statistically significant ($2,217.19 vs $1,424.00, p=0.192). The average cost of admissions with preventable DRPs was sizeable especially to most elderly who could no longer earn stable incomes.