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Pharmacist-led medication reviews for geriatric residents in German long-term care facilities

BACKGROUND: The benefit of medication reviews for long-term care (LTC) residents has been generally recognized throughout health care systems. Whereas many studies showed the impact of comprehensive medication reviews performed by specialized clinical pharmacists, little is known about the impact of...

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Autores principales: Bitter, Kerstin, Pehe, Christina, Krüger, Manfred, Heuer, Gabriela, Quinke, Regine, Jaehde, Ulrich
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371600/
https://www.ncbi.nlm.nih.gov/pubmed/30744564
http://dx.doi.org/10.1186/s12877-019-1052-z
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author Bitter, Kerstin
Pehe, Christina
Krüger, Manfred
Heuer, Gabriela
Quinke, Regine
Jaehde, Ulrich
author_facet Bitter, Kerstin
Pehe, Christina
Krüger, Manfred
Heuer, Gabriela
Quinke, Regine
Jaehde, Ulrich
author_sort Bitter, Kerstin
collection PubMed
description BACKGROUND: The benefit of medication reviews for long-term care (LTC) residents has been generally recognized throughout health care systems. Whereas many studies showed the impact of comprehensive medication reviews performed by specialized clinical pharmacists, little is known about the impact of medication reviews performed by community pharmacists. Involving them in the provision of medication reviews may help satisfy the increasing demand for ensuring medication safety. METHODS: Community pharmacists supplying drugs to the LTC facilities performed a medication review for German LTC residents aged at least 65 years and taking five or more drugs per day based on the patients’ medication only. Documented potential drug-related problems (DRPs) and the implementation rate of pharmaceutical interventions were evaluated descriptively. To assess the quality of the medication reviews, we developed a corresponding reference system based on the analysis of two experienced clinical pharmacists. RESULTS: Twelve pharmacies performed medication reviews for 94 LTC residents. Overall, the pharmacists documented 154 potential DRPs (mean 1.6 per patient, SD 1.5) of which the most common were drug-drug interactions (40%) followed by potentially inappropriate medication (PIM) (16%) and inappropriate dosages (14%). 33% of the pharmacists’ interventions to solve DRPs were successfully implemented, mostly dosage adjustments. The identification of potentially severe drug-drug interactions and PIM showed the highest agreement (88 and 73%) with the reference system. CONCLUSIONS: The medication review program of community pharmacists for LTC residents led to the identification of relevant DRPs. The reference system assessing the quality of the service can contribute to its transparency and reveals the potential for its improvement. The community pharmacists’ knowledge of the LTC residents and their relation to the prescribers is crucial for providing successful medication reviews.
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spelling pubmed-63716002019-02-25 Pharmacist-led medication reviews for geriatric residents in German long-term care facilities Bitter, Kerstin Pehe, Christina Krüger, Manfred Heuer, Gabriela Quinke, Regine Jaehde, Ulrich BMC Geriatr Research Article BACKGROUND: The benefit of medication reviews for long-term care (LTC) residents has been generally recognized throughout health care systems. Whereas many studies showed the impact of comprehensive medication reviews performed by specialized clinical pharmacists, little is known about the impact of medication reviews performed by community pharmacists. Involving them in the provision of medication reviews may help satisfy the increasing demand for ensuring medication safety. METHODS: Community pharmacists supplying drugs to the LTC facilities performed a medication review for German LTC residents aged at least 65 years and taking five or more drugs per day based on the patients’ medication only. Documented potential drug-related problems (DRPs) and the implementation rate of pharmaceutical interventions were evaluated descriptively. To assess the quality of the medication reviews, we developed a corresponding reference system based on the analysis of two experienced clinical pharmacists. RESULTS: Twelve pharmacies performed medication reviews for 94 LTC residents. Overall, the pharmacists documented 154 potential DRPs (mean 1.6 per patient, SD 1.5) of which the most common were drug-drug interactions (40%) followed by potentially inappropriate medication (PIM) (16%) and inappropriate dosages (14%). 33% of the pharmacists’ interventions to solve DRPs were successfully implemented, mostly dosage adjustments. The identification of potentially severe drug-drug interactions and PIM showed the highest agreement (88 and 73%) with the reference system. CONCLUSIONS: The medication review program of community pharmacists for LTC residents led to the identification of relevant DRPs. The reference system assessing the quality of the service can contribute to its transparency and reveals the potential for its improvement. The community pharmacists’ knowledge of the LTC residents and their relation to the prescribers is crucial for providing successful medication reviews. BioMed Central 2019-02-11 /pmc/articles/PMC6371600/ /pubmed/30744564 http://dx.doi.org/10.1186/s12877-019-1052-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Bitter, Kerstin
Pehe, Christina
Krüger, Manfred
Heuer, Gabriela
Quinke, Regine
Jaehde, Ulrich
Pharmacist-led medication reviews for geriatric residents in German long-term care facilities
title Pharmacist-led medication reviews for geriatric residents in German long-term care facilities
title_full Pharmacist-led medication reviews for geriatric residents in German long-term care facilities
title_fullStr Pharmacist-led medication reviews for geriatric residents in German long-term care facilities
title_full_unstemmed Pharmacist-led medication reviews for geriatric residents in German long-term care facilities
title_short Pharmacist-led medication reviews for geriatric residents in German long-term care facilities
title_sort pharmacist-led medication reviews for geriatric residents in german long-term care facilities
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371600/
https://www.ncbi.nlm.nih.gov/pubmed/30744564
http://dx.doi.org/10.1186/s12877-019-1052-z
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