Identification of Drug-Related Problems and Assessment of Health-Related Quality of Life in Elderly Multimorbid Inpatients with Stroke

This study seeks to identify and assess the severity of drug-related problems (DRPs), analyze risk factors and evaluate the impact of DRPs on the health-related quality of life (HRQoL) among elderly multimorbid inpatients with stroke in the Comprehensive Stroke Center (CSC) in China.

A two-year retrospective study was conducted at a tertiary hospital among elderly multimorbid inpatients with stroke. Medication review, HRQoL assessment and stroke-associated clinical scales assessment by clinical pharmacists or the medical team.

An analysis of 592 patients revealed 576 DRPs. The mean age of patients was 73.64 ± 7.96 years old. 583 (55.6%) cases had at least one DRP, with an average of 1.53 ± 0.94 DRPs per patient. The most common multimorbidity pattern was co-existing hypertension and stroke (17.4%). "Drug selection, C1" emerged as the predominant cause of DRPs (54.0%; 311/576), followed by "Patient related, C7" (18.2%; 105/576). Most DRPs (79.3%, 457/576) were low severity (B-D); the remaining 20.7% (119/576) were high severity (E-H). Increased hospital length of stays (LOS) and coexisting atrial fibrillation were identified as significant factors influencing the occurrence of DRPs (p < 0.05). The quantity of DRPs showed a weak negative correlation with HRQoL scores (r = -0.291, p < 0.001), as well as moderate positive correlations with both the mRS scores (r = 0.304, p < 0.001) and the NIHSS scores (r = 0.306, p < 0.001).

DRPs are prevalent among elderly multimorbid inpatients with stroke in CSC and are mainly caused by drug selection and patient-related problems. Prolonged hospitalization days and the presence of atrial fibrillation were identified as significant risk factors for occurrence of DRPs in elderly multimorbid inpatients with stroke. Pharmaceutical services of medication review could assist in the identification of DRPs at the CSC.