Risk Factors for Drug Therapy Problems Among Cambodian Americans with Complex Needs: a Cross-sectional, Observational Study

Overview

Journal Health Psychol Behav Med

Date 2022 Jan 28

PMID 35087696

Authors

Julie A Wagner

Angela Bermudez-Millan

S Megan Berthold

Thomas Buckley

Orfeu M Buxton

Richard Feinn

Theanvy Kuoch

Sengly Kong

Mackenzie Lim

Christina Polomoff

Mary Scully

Affiliations

Soon will be listed here.

Abstract

Background: Pharmaceutical drug therapy problems (DTPs) are a major public health problem. We examined patient-level risk factors for DTPs among Cambodian Americans.

Methods: Community health workers (CHWs) verbally administered surveys and completed a detailed medication review form with participants. A doctoral-level pharmacist reviewed the form with the patient and CHW to determine DTP number and type (appropriateness, effectiveness, safety, and adherence).

Results: Participants ( = 63) averaged 55 years old, 6 years of education, 52% were married, 87% spoke Khmer at home, with modal household income <$20,000 (41%). The percentage of participants with DTPs was: 45% appropriateness, 25% effectiveness, 64% safety, and 30% adherence, averaging 3.7 DTPs per patient. In multiple regressions, patient characteristics uniquely predicted each type of DTP. In a multiple regression controlling for number of medications, being married reduced total DTPs (IRR = 0.70) and being depressed increased total DTPs (IRR = 1.26).

Conclusions: Vulnerable patients should be prioritized for pharmacist/CHW teams to identify DTPs. ClinicalTrials.gov identifier: NCT02502929.

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References

Levine A, Emonds E, Smith M, Rickles N, Kuchel G, Steffens D . Pharmacist Identification of Medication Therapy Problems Involving Cognition Among Older Adults Followed by a Home-Based Care Team. Drugs Aging. 2020; 38(2):157-168. DOI: 10.1007/s40266-020-00821-7. View

Marshall G, Schell T, Wong E, Berthold S, Hambarsoomian K, Elliott M . Diabetes and Cardiovascular Disease Risk in Cambodian Refugees. J Immigr Minor Health. 2015; 18(1):110-7. PMC: 4526445. DOI: 10.1007/s10903-014-0142-4. View

Mitchell P, Powell L, Blumenthal J, Norten J, Ironson G, Pitula C . A short social support measure for patients recovering from myocardial infarction: the ENRICHD Social Support Inventory. J Cardiopulm Rehabil. 2003; 23(6):398-403. DOI: 10.1097/00008483-200311000-00001. View

Smith M, Giuliano M, Starkowski M . In Connecticut: improving patient medication management in primary care. Health Aff (Millwood). 2011; 30(4):646-54. DOI: 10.1377/hlthaff.2011.0002. View

Wong E, Marshall G, Schell T, Elliott M, Hambarsoomians K, Chun C . Barriers to mental health care utilization for U.S. Cambodian refugees. J Consult Clin Psychol. 2006; 74(6):1116-20. DOI: 10.1037/0022-006X.74.6.1116. View

Kondo N, Nakamura F, Yamazaki S, Yamamoto Y, Akizawa T, Akiba T . Prescription of potentially inappropriate medications to elderly hemodialysis patients: prevalence and predictors. Nephrol Dial Transplant. 2014; 30(3):498-505. DOI: 10.1093/ndt/gfu070. View

Cella D, Yount S, Rothrock N, Gershon R, Cook K, Reeve B . The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years. Med Care. 2007; 45(5 Suppl 1):S3-S11. PMC: 2829758. DOI: 10.1097/01.mlr.0000258615.42478.55. View

Xiong T, Li J, Mao J, Xu J . Medication-related problems among community-dwelling older adults after recent hospital discharge in mainland China. Nurs Res. 2014; 63(6):439-45. DOI: 10.1097/NNR.0000000000000064. View

Marshall G, Schell T, Elliott M, Berthold S, Chun C . Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA. 2005; 294(5):571-9. DOI: 10.1001/jama.294.5.571. View

10.

Wagner J, Berthold S, Buckley T, Kong S, Kuoch T, Scully M . Diabetes among refugee populations: what newly arriving refugees can learn from resettled Cambodians. Curr Diab Rep. 2015; 15(8):56. DOI: 10.1007/s11892-015-0618-1. View

11.

Aggarwal B, Liao M, Mosca L . Medication adherence is associated with having a caregiver among cardiac patients. Ann Behav Med. 2013; 46(2):237-42. PMC: 3787847. DOI: 10.1007/s12160-013-9492-8. View

12.

Polomoff C, Bermudez-Millan A, Buckley T, Buxton O, Feinn R, Kong S . Pharmacists and community health workers improve medication-related process outcomes among Cambodian Americans with depression and risk for diabetes. J Am Pharm Assoc (2003). 2021; 62(2):496-504.e1. PMC: 8934259. DOI: 10.1016/j.japh.2021.10.031. View

13.

Hays R, Bjorner J, Revicki D, Spritzer K, Cella D . Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res. 2009; 18(7):873-80. PMC: 2724630. DOI: 10.1007/s11136-009-9496-9. View

14.

Oliveira D, Brummel A, Miller D . Medication Therapy Management: 10 Years of Experience in a Large Integrated Health Care System. J Manag Care Spec Pharm. 2020; 26(9):1057-1066. PMC: 10391185. DOI: 10.18553/jmcp.2020.26.9.1057. View

15.

Snyder M, Frail C, Jaynes H, Pater K, Zillich A . Predictors of medication-related problems among medicaid patients participating in a pharmacist-provided telephonic medication therapy management program. Pharmacotherapy. 2014; 34(10):1022-32. PMC: 4426336. DOI: 10.1002/phar.1462. View

16.

Lee J, Yang J, Stockl K, Lew H, Solow B . Evaluation of Eligibility Criteria Used to Identify Patients for Medication Therapy Management Services: A Retrospective Cohort Study in a Medicare Advantage Part D Population. J Manag Care Spec Pharm. 2016; 22(1):22-30. PMC: 10398293. DOI: 10.18553/jmcp.2016.22.1.22. View

17.

Cherrington A, Ayala G, Amick H, Scarinci I, Allison J, Corbie-Smith G . Applying the community health worker model to diabetes management: using mixed methods to assess implementation and effectiveness. J Health Care Poor Underserved. 2008; 19(4):1044-59. DOI: 10.1353/hpu.0.0077. View

18.

Berthold S, Kong S, Mollica R, Kuoch T, Scully M, Franke T . Comorbid mental and physical health and health access in Cambodian refugees in the US. J Community Health. 2014; 39(6):1045-52. DOI: 10.1007/s10900-014-9861-7. View

19.

Berthold S, Loomis A, Kuoch T, Scully M, Hin-McCormick M, Casavant B . Social Disconnection as a Risk Factor for Health among Cambodian Refugees and Their Offspring in the United States. J Immigr Minor Health. 2018; 21(2):290-298. DOI: 10.1007/s10903-018-0760-3. View

20.

Degu A, Njogu P, Weru I, Karimi P . Assessment of drug therapy problems among patients with cervical cancer at Kenyatta National Hospital, Kenya. Gynecol Oncol Res Pract. 2017; 4:15. PMC: 5648473. DOI: 10.1186/s40661-017-0054-9. View