Pharmaceutical Interventions During Inpatient Care in a French Geriatric Hospital

Since aging is associated with pharmacokinetic and pharmacodynamic changes, polypharmacy is particularly harmful in older adults. Meanwhile, clinical pharmacists contribute to safer prescribing by applying their clinical expertise during medication review. Therefore, this study aimed to characterize potential drug-related problems through the analysis of routine pharmaceutical interventions.

Data were collected from the electronic health record between 2019 and 2025; potentially inappropriate medications and high-risk medications were identified. Drug-related problems were categorized according to the Pharmaceutical Care Network Europe classification.

Pharmacists performed 12,856 pharmaceutical interventions, of which prescribers accepted 65%. The mean patient age was 87.5 years (range, 65-113 years), and 60.2% of patients were female. Among all pharmaceutical interventions, 1779 involved a potentially inappropriate medication. The most frequent causes of drug-related problems were related to dose selection (39.8%), drug selection (14.3%), treatment duration (10.1%), and treatment safety (9.3%). The most commonly targeted drug categories were the nervous system (24.7%), the digestive tract and metabolism (21.5%), blood and hematopoietic organs (19.8%), and the cardiovascular system (13.6%).

Pharmaceutical interventions that prevent prescribing errors in older adults are essential in clinical practice. Understanding potential drug-related problems and the nature of pharmaceutical interventions can help ensure safe pharmacotherapy by alerting prescribers and caregivers to major medication-related risks.