Intervention for improving the appropriateness of physician orders for oral medications in geriatric VIP patients during the journey to JCI accreditation

Figures & data

Table 1 Geriatric patients information and indicators of rational drug use

Indicators	Before JCI accreditation (April 1, 2012)	After JCI accreditation (April 1, 2013)
Number of patients receiving oral medications	36	42
Male	27	36
Female	9	6
Age (years) (mean ± SD)	83.5 ± 5.8	82.5 ± 8.7
Number of oral medications per patient (mean ± SD)	12.6 ± 5.8	12.8 ± 6.1
Number of patients receiving oral medications
≥20	4	7
10–19	23	24
<10	9	12
Number of diagnoses (mean ± SD)	10.5 ± 3.5	9.2 ± 4.1
Number of patients with allergy history	7	10
Number of physician orders for oral medications	486	601
Percentage of use of generic names	100%	100%
Number of drug-related problems (DRPs)	63	21
Proportion of DRPs#	13.0%	3.5%
Detailed information for DRPs
Drug–drug interactions (DDIs) with potential adverse consequences#	7	0
_Therapeutic duplication or combination use of two drugs within the same therapeutic or structurally similar classΔ	10	4
Lack of therapeutic drug monitoring	8	5
Inappropriate dosing timeΔ	12	5
Inappropriate dosing frequencyΔ	14	5
Inappropriate dosing route#	10	1
Too large a dose	2	1
Beyond approved indications	2	0
Proportion of combination use of gastrointestinal protective medications for patients taking aspirin	50.0% (4/8)	77.8% (7/9)

Notes:

# P < 0.01,

Δ P < 0.05 (first phase vs second phase). Differences between the two phases were tested for statistical significance using Pearson’s Chi-square test. A P-value < 0.05 was considered to be statistically significant. A P-value < 0.01 was considered to be highly significant. Proportion of DRPs was calculated as the value of number of DRPs divided by number of physician orders for oral medications.

Abbreviation: SD, standard deviation.