DRUG-RELATED PROBLEMS in HOME CARE PATIENTS
Bibliographic record
Abstract
Home health care programs have been recognized as a cost-effective method of providing health care to patients in the familiar surroundings of their home. The services provided by such a program have been viewed as an extension of those found in hospital and have included nursing and social services as well as occupational and physical therapy. However, pharmacy as yet has not been regarded among those services considered necessary. This study was designed to determine if patients in a home care program, specifically the Saskatoon Rehabilitation Home Care Program (SRHCP) experience difficulties with their drug treatment regimens. The objectives of the study were to assess the number of drug-related problems faced by patients and to identify factors contributing to these problems. The study population consisted of the 432 patients registered in the SRHCP in January 1985. From this group, 74 patients were chosen at random and were personally interviewed by the author using a pre-tested questionnaire. Data was analyzed using the SPSS-X computer program package . Frequencies of responses were tabulated for all questions. Relationships between selected variables were examined by nonparametric correlation (Spearman's rank correlation coefficient) or chi-square analysis. Probability values < 0.05 were considered statistically significant. Among patients registered with the SRHCP , females outnumbered the males in a ratio of approximately 1.4 to 1. Patients 65 years and older comprised 60.3% of this population; 33.8% of all patients lived alone. Twenty-five patients (35.7%) were found to be noncompliant with one or more of their medications. Fifty-seven percent of the patients knew the use of all their prescribed drugs and only 4 patients (5.7%) did not know the use of any. More than 50% of patients stated they had not been given information on their prescription drugs and 87.7% named the physician as the first person they would contact if they had a problem with any of their medication. Eighty-one percent of patients said they bought their prescription drugs at one pharmacy only. Fifty-four patients were taking nonprescription drug products with the average number per patient being 1.7 for those patients <65 years and 2.4 for those 65 years and older. Of the tota1154 nonprescription drugs being taken, 72.7% were used for an officially recommended purpose and 96.7% were taken in an officially approved dose. Sixty-three percent of patients purchased their nonprescription drugs at a pharmacy. Fifty-two patients (70.3%) interviewed were assessed as having one or more drug-related problems. More of these problems were patient-related than physician-related. An increasing number of drug-related problems in a patient was associated with an increasing number of diagnoses, an increasing number of prescription drugs and a decreasing degree of patient compliance with drug treatment regimens. Neither patient compliance nor the total number of drug-related problems were related to the age of the patient. The number of prescription drugs taken influenced patient compliance. Patients taking more drugs were compliant with a smaller percentage of their prescription medications. There was no difference found between patients <65 years and those 65 yr and older with respect to the number of drugs (both prescribed drugs & OTC drug products)being taken by the patient, the percentage of prescription drugs for which the patient knew the name and the percentage of prescription drugs for which the patient knew the use. A significant portion of the patients in the SRHCP had drug-related problems which could be identified by a pharmacist. As a full-time member of the home care team, a pharmacist could assist in identifying and solving drug-related problems by specific interventions with patients and physicians and by general education programs for patients and home care personnel.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".