Evidence-based nursing to reduce polypharmacy risks in older cholecystectomy patients

Abstract

BACKGROUND

With an aging society, older patients undergoing cholecystectomy often have multiple chronic diseases and require long-term multi-medication. Medication complexity significantly increases the risk of medication errors and adverse reactions, and effective nursing interventions are urgently required to ensure medication safety.

AIM

To investigate the efficacy of evidence-based nursing practices in mitigating polypharmacy risks among Suzhou Municipal Hospital Road Front Yard Area, thereby providing clinical guidance.

METHODS

The sixty older patients who underwent cholecystectomy between September 2024 and September 2025 treated with polypharmacy were enrolled. Using random number tables, hey were divided into study and control groups (n = 30 each), who received routine medication nursing and evidence-based nursing, respectively. Pre-intervention and post-intervention comparisons were made between groups for medication knowledge, competence, and adherence scores. The incidences of duplicate medications, missed doses, self-discontinuation, unauthorized alterations, schedule changes, and adverse reaction rates assessed potential medication risks.

RESULTS

Both the study and control groups showed significant increases in medication knowledge, management competence, and adherence scores after intervention (all P < 0.05). The study group had higher post-intervention scores (medication knowledge: 87.29 ± 5.09 vs 70.62 ± 5.38; medication management competence: 63.22 ± 3.11 vs 56.19 ± 4.08; medication adherence: 7.13 ± 1.04 vs 6.05 ± 1.03, all P < 0.05). The incidence of duplicate medication, missed doses, self-discontinuation, unauthorized dose alterations, and schedule modifications decreased in both groups post-intervention (all P < 0.05), with lower rates in the study group (duplicate medication: 13.33% vs 30.0%; missed doses: 10.0% vs 26.67%; all P < 0.05). The study group had a lower adverse reaction rate (3.33% vs 26.67%, P < 0.05) and more patients with potential medication hazard level 0 (83.33% vs 53.33%), while fewer patients had level 2 and 3 hazards (3.33% vs 16.67% and 0% vs 10.00%, respectively; all P < 0.05).

CONCLUSION

Evidence-based nursing for polypharmacy risks in older adults undergoing cholecystectomy can enhance medication awareness, improve management and adherence, reduce adverse behaviors, and lower adverse reactions and hazard levels.

Keywords: Evidence-based nursing; Polypharmacy; Older patients; Cholecystectomy; Risk management

Core Tip: Evidence-based nursing effectively reduced the risk of polypharmacy in older patients undergoing cholecystectomy. Improving medication knowledge, management capability, and adherence minimizes adverse medication behaviors, such as duplication, missed doses, and self-discontinuation. This approach also lowers adverse reaction rates and potential medication hazard levels, thereby providing strong clinical support for safer perioperative care.