Clinical Pharmacology & Biopharmaceutics
Open Access

Abstract

Background: Polypharmacy (PPRx) is common among US patient population, and may be as high as 50% in patients over 65. PPRx among inpatients can be associated with an increased rate of medical errors, adverse reactions, prolong hospitalization and cost. Aim: The goals of the present project were to explore the prevalence of PPRx at our facility and raise awareness and provide guidance regarding reduction of PPRx. Methods: Using electronic medical record we reviewed the medication list for the inpatients admitted at our facility in the spring of 2016. PPRx was defined as taking more than 10 drugs. Hospitalists were informed about the risks and possible consequences of PPRx and modalities to correct them. Interventions via multidisciplinary team work, safety rounds and improve communication in addressing PPRx were implemented, as part of a quality/safety improvement project. Results: Among the 105 inpatients, 87 (83%) experienced PPRx, taking an average of 15.6 medications. The average patient age was 48.7�±10.7 years, 78/87 (90%) were male and 9/87 (10%) were female. These patients received a total of 1353 medications, of which 56% were scheduled medications (SM) and 44% were PRN meds. Among many patients with PPRx: H2 Blockers/PPIâ��s were prescribed without a clinical diagnosis; Benadryl was frequently used as a PRN sleep medication; and muscle relaxant and narcotics were frequently prescribed concomitantly. The project outcome reflected in the April 2016 data, which compared with the data from April 2015 showed an 80% decrease of prescribed multiple sedating agents. Conclusion: Successful interventions to decrease polypharmacy require multidisciplinary team work, educational interventions and increase communication.

Biography

Stefan Bughi is a Clinical Associate Professor of Medicine at the Keck School of Medicine, University of Southern California in Los Angeles in the Division of Diabetes/Endocrinology. He is board certified in Internal Medicine and Endocrinology and presently working as a Physician Specialist at Rancho Los Amigos National Rehabilitation Center (RLANRC). He is the Chair of Graduate Medical Education, the Chair of the Physician Well-Being Committee and the Physician Patient Safety Officer at RLANRC. He is also a Member of the Medication Safety Committee. He is a Fellow of the American Board of Diabetes and Fellow of the American Institute of Stress. He has completed his Master’s in Academic Medicine from USC Keck School of Medicine. His research interests include human factor and patient safety, endocrinology of stress and the effects of stress on psychosomatic disorders and stress and medical profession. He has presented his research data at local, national and international meetings.

Email: sbughi@dhs.lacounty.gov