Closed-loop medication safety management reduces inappropriate medication in elderly patients with rheumatic and immunologic diseases

Q: What problem does the study address in elderly patients?

It targets potentially inappropriate medication in elderly patients with rheumatic and immunologic diseases, which can lead to adverse drug reactions, poorer adherence, and lower satisfaction.

Q: How was the closed-loop medication safety management implemented?

The intervention involved participation of clinical pharmacists, digital-system risk alerts, and full-process medication tracking.

Q: What were the main effectiveness results after the intervention?

PIM incidence decreased to 16% from 58%, appropriate prescribing increased to 86% from 44%, ADR incidence decreased to 8% from 24%, and both adherence (90%) and patient satisfaction (96%) increased versus the control group.

Sep 30, 2026

Uploaded by WPS_1790064749

Elderly patients with rheumatic and immunologic diseases often need long-term combination therapy, making them highly vulnerable to potentially inappropriate medications (PIM) that can increase adverse drug reactions (ADRs), weaken adherence, and reduce satisfaction. A single-center retrospective controlled study compared 50 intervention inpatients with 50 controls from 2019–2022. Closed-loop management added clinical pharmacists, digital risk alerts, and full-process medication tracking. Post-intervention, PIM incidence fell to 16% vs 58%, appropriate prescribing rose to 86% vs 44%, and ADR incidence dropped to 8% vs 24%, alongside higher adherence (90%) and satisfaction (96%).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

Study design and intervention

Outcomes: PIM, prescribing appropriateness, ADRs

Outcomes: adherence and patient satisfaction

Results summary and implications

® Observational Study Closed-loop medication safety management reduces inappropriate medication in elderly patients with rheumatic and immunologic diseases Dan Chen, MMa , Jing Feng, MMa , Zhihui Chen, MMb , Miao Chen, MMc ,* | Abstract
Elderly patients with rheumatic and immunologic diseases often require long-term combination drug therapy due to prolonged disease duration and the presence of multiple chronic comorbidities. This population is particularly susceptible to potentially inappropriate medication (PIM), which can increase the risk of adverse drug reactions (ADRs), compromise treatment adherence, and lower overall patient satisfaction. Traditional medication management models mainly rely on static review and lack comprehensive process-based interventions, which are insufficient to address the increasingly complex medication needs of elderly patients. Therefore, there is an urgent need for a more systematic and efficient management mechanism. This single-center retrospective controlled study included 100 elderly inpatients with rheumatic and immunologic diseases treated in our hospital from January 2019 to December 2022. Patients were divided into an intervention group (n = 50) and a control group (n = 50) based on whether they received medication safety closed-loop management. The intervention included participation of clinical pharmacists, risk alerts through digital systems, and full-process medication tracking. The 2 groups were compared in terms of PIM incidence, medication appropriateness, ADRs, medication adherence, and patient satisfaction. Baseline characteristics showed no statistically significant differences between the 2 groups (P > .05), indicating good comparability. After the intervention, the PIM incidence in the intervention group significantly dropped to 16%, markedly lower than the 58% in the control group (P < .05) . The rate of appropriate prescribing use increased to 86% in the intervention group versus 44% in the control group (P < .05) . The incidence of ADR decreased from 24 to 8% in the intervention group, also significantly lower than in the control group (P < .05) . Moreover, medication adherence rose to 90%, and patient satisfaction reached 96%, both significantly higher than those in the control group (P < .05) . Medication safety closed-loop management, through the deep integration of information technology and multidisciplinary collaboration, significantly improves medication safety and appropriateness in elderly patients with rheumatic and immunologic diseases. It also reduces ADRs and enhances adherence and patient satisfaction, demonstrating substantial clinical value and potential for broader implementation. | | --- | | Abbreviations: ADR = adverse drug reaction, CDSS = clinical decision support system, PIM = potentially inappropriate medication. | | Keywords: closed-loop management, elderly patients, geriatrics, medication safety, polypharmacy, potentially inappropriate medication, rheumatic and immunologic diseases | 1. Introduction With the intensification of population aging, the proportion of elderly individuals in clinical healthcare continues to rise. [1] Rheumatic and autoimmune diseases, as common chronic illnesses among the elderly, are characterized by high incidence, long disease duration, and frequent relapses. They are often accompanied by multiple comorbidities such as hypertension, diabetes, and osteoporosis. [2,3] In order to control symptoms, delay disease progression, and reduce complications, such patients usually require long-term and multi-drug combination therapy.[4] However, the coexistence of multiple diseases and the widespread use of multiple medications significantly increase the complexity of drug therapy in elderly patients with rheumatic and autoimmune diseases, particularly raising concerns about potentially inappropriate medications (PIMs) . [5,6] PIM refers to medication use behaviors where clinical evidence suggests that, for

FAQs

What problem does the study address in elderly patients?

It targets potentially inappropriate medication in elderly patients with rheumatic and immunologic diseases, which can lead to adverse drug reactions, poorer adherence, and lower satisfaction.

How was the closed-loop medication safety management implemented?

The intervention involved participation of clinical pharmacists, digital-system risk alerts, and full-process medication tracking.

What were the main effectiveness results after the intervention?

PIM incidence decreased to 16% from 58%, appropriate prescribing increased to 86% from 44%, ADR incidence decreased to 8% from 24%, and both adherence (90%) and patient satisfaction (96%) increased versus the control group.

Sep 30, 2026

Uploaded by WPS_1790064749