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

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.