Risk factors for drug therapy problems among Cambodian Americans with complex needs: a cross-sectional, observational study

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

doi:10.1080/21642850.2021.2021917

Risk factors for drug therapy problems among Cambodian Americans with complex needs: a cross-sectional, observational study

Health Psychol Behav Med. 2022 Jan 24;10(1):145-159. doi: 10.1080/21642850.2021.2021917. eCollection 2022.

Authors

Affiliations

¹ Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, Farmington, CT, USA.
² Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA.
³ University of Connecticut School of Social Work, Hartford, CT, USA.
⁴ Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA.
⁵ Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA.
⁶ Department of Medical Sciences, Quinnipiac University School of Medicine, Hamden, CT, USA.
⁷ Khmer Health Advocates, West Hartford, CT, USA.

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 (n = 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.Trial registration: ClinicalTrials.gov identifier: NCT02502929.

Keywords: Cambodian; Community health workers‌; Drug therapy problem; depression; risk factors.

Associated data

ClinicalTrials.gov/NCT02502929

Grants and funding

This work was supported by the National Institutes of Health to Julie Wagner [grant number DK103663].