The PCNE 9.0 Classification for Drug-Related Problems Identified in Geriatric Patients in a Secondary Hospital at East Borneo, Indonesia

Introduction: The elderly age group causes older people to require more drugs (polypharmacy) than adults; the function of organs such as the liver and kidneys that play a role in processing medicines that enter the body has decreased, resulting in a high probability that the drug will accumulate in the bodyl. Identifying drug-related problems (DRPs) in older people is essential to reduce morbidity, mortality, and drug therapy costs2,3. Medication reviews have been shown to improve the use of high-risk medications and the accuracy of medication regimens in geriatric patients4. Aim: To identify drug-related problems and determinants in geriatric patients admitted to a secondary hospital in Indonesia. Methods: This study was designed as a cross-sectional with retrospective data collected based on the medical records of geriatric patients from January 2019 to December 2021 at the inpatient geriatric department of a secondary hospital in East Borneo. Inclusion criteria are patients aged 60 - 79, geriatric patients hospitalized from January 2019 to December 2021, and geriatric with complete and legible medical records. The data was presented in tabular form and analyzed descriptively according to the literature until the results and conclusions were obtained. The analysis was carried out descriptively by describing the demographic characteristics of geriatric patients and the type and causes of DRPs identified and classified based on the Pharmaceutical Care Network of Europe's (PCNE) classification system V9.0. Results: The results of the study of 614 patients studied showed that the percentage of the characteristics of 614 elderly patients mainly were aged 60-69 years (79%), female (56.4%), and the number of medications was >5 (73%). There were 462 patients (75,2%) who experienced DRPs. Most problems were related to treatment effectiveness (74.1%) and treatment safety (36.6%). The causes of DRPs are mainly related to inappropriate monitoring, including therapeutic drug monitoring (16.3%), an improper combination of drugs, or drugs and dietary/herbal supplements (40.5%), drug dose was too high (14.5%), drug dose was too low (4.9%) and inappropriate timing of administration or dosing intervals (4.7%). There was a correlation between risk factors for polypharmacy (p = 0.011) and comorbidities (p = 0.007) with the incidence of DRPs. Conclusion: Drug-related problems were substantially serious among geriatric inpatients with polypharmacy and comorbidities as they ha