• Sandra Vezmar Kovačević, Branislava Miljković, Milica Ćulafić, Milena Kovačević, Bojana Golubović, Marija Jovanović, Katarina Vučićević, and Johan J de Gier.
• Faculty of Pharmacy, Department of Pharmacokinetics and Clinical Pharmacy, University of Belgrade, Belgrade, Serbia.
• J Eval Clin Pract. 2017 Aug 1; 23 (4): 860-865.

Aims And ObjectivesTargeting older patients with predictive factors for drug-related problems (DRPs) could make clinical medication reviews more cost-effective. The aim of this study was to identify the number, type, and potential predictive factors for DRPs in older polypharmacy patients.MethodsCommunity pharmacists performed clinical medication reviews and documented DRPs, types of interventions, and their implementation in older patients.ResultsThree hundred eighty-eight medication reviews were analyzed, 964 DRPs (average 2.5 ± 1.9), and 1022 interventions (average 2.6 ± 2.0) were identified. The overall implementation rate of interventions was 70.1%, the highest was observed in interventions aiming to resolve the lack of therapy monitoring (86.8%). Patients with ≥12 medications had an increased risk of ≥5 DRPs (P < .001). Asthma was associated with lack of adherence (P = .002), lack of aspirin, statins, and proton pump inhibitors use with additional therapy needed (P = .002-.004). Predictive factors for drug interactions were antihypertensive medications and/or medications with narrow therapeutic index (P < .05). Lack of efficacy was associated with diabetes (P = .006). Nonsteroidal anti-inflammatory drugs were risk factors for inappropriate drug selection (P = .002). Lack of monitoring was associated with hypertension (P = .013), whereas benzodiazepines (P < .001) and aspirin (P = .021) were overused.ConclusionPatients with asthma, hypertension, and diabetes and lack of statin, antithrombotic agent, and/or proton pump inhibitor use were associated with higher risks for DRPs.© 2017 John Wiley & Sons, Ltd.

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