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Effects of non‐dispensing pharmacists integrated in general practice on medication‐related hospitalisations

AIMS: To evaluate the effect of non‐dispensing pharmacists (NDPs) integrated in general practice on medication‐related hospitalisations, drug burden index and costs in patients at high risk of medication problems (being 65 years or older and using 5 or more chronic medications). METHODS: This was a...

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Autores principales: Sloeserwij, V.M., Hazen, A.C.M., Zwart, D.L.M., Leendertse, A.J., Poldervaart, J.M., de Bont, A.A., de Gier, J.J., Bouvy, M.L., de Wit, N.J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783584/
https://www.ncbi.nlm.nih.gov/pubmed/31240722
http://dx.doi.org/10.1111/bcp.14041
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author Sloeserwij, V.M.
Hazen, A.C.M.
Zwart, D.L.M.
Leendertse, A.J.
Poldervaart, J.M.
de Bont, A.A.
de Gier, J.J.
Bouvy, M.L.
de Wit, N.J.
author_facet Sloeserwij, V.M.
Hazen, A.C.M.
Zwart, D.L.M.
Leendertse, A.J.
Poldervaart, J.M.
de Bont, A.A.
de Gier, J.J.
Bouvy, M.L.
de Wit, N.J.
author_sort Sloeserwij, V.M.
collection PubMed
description AIMS: To evaluate the effect of non‐dispensing pharmacists (NDPs) integrated in general practice on medication‐related hospitalisations, drug burden index and costs in patients at high risk of medication problems (being 65 years or older and using 5 or more chronic medications). METHODS: This was a multicentre, nonrandomised, controlled intervention study with pre–post comparison (2013 vs June 2014 to May 2015) in 25 general practices in the Netherlands, comparing NDP‐led care (intervention) with 2 current pharmaceutical care models (usual care and usual care plus). In the intervention group, 10 specially trained NDPs were employed in general practices to take integral responsibility for the pharmaceutical care. They provided a broad range of medication therapy management services both on patient level (e.g. clinical medication review) and practice level (e.g. quality improvement projects). In the control groups, pharmaceutical care was provided as usual by general practitioners and community pharmacists, or as usual plus, when pharmacists were additionally trained in performing medication reviews. RESULTS: Overall, 822 medication‐related hospitalisations were identified among 11 281 high‐risk patients during the intervention period. After adjustment for clustering and potential confounders, the rate ratio of medication‐related hospitalisations in the intervention group compared to usual care was 0.68 (95% confidence interval: 0.57–0.82) and 1.05 (95% confidence interval: 0.73–1.52) compared to usual care plus. No differences in drug burden index or costs were found. CONCLUSIONS: In general practices with an integrated NDP, the rate of medication‐related hospitalisations is lower compared to usual care. No differences with usual care plus were found.
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spelling pubmed-67835842019-10-17 Effects of non‐dispensing pharmacists integrated in general practice on medication‐related hospitalisations Sloeserwij, V.M. Hazen, A.C.M. Zwart, D.L.M. Leendertse, A.J. Poldervaart, J.M. de Bont, A.A. de Gier, J.J. Bouvy, M.L. de Wit, N.J. Br J Clin Pharmacol Original Articles AIMS: To evaluate the effect of non‐dispensing pharmacists (NDPs) integrated in general practice on medication‐related hospitalisations, drug burden index and costs in patients at high risk of medication problems (being 65 years or older and using 5 or more chronic medications). METHODS: This was a multicentre, nonrandomised, controlled intervention study with pre–post comparison (2013 vs June 2014 to May 2015) in 25 general practices in the Netherlands, comparing NDP‐led care (intervention) with 2 current pharmaceutical care models (usual care and usual care plus). In the intervention group, 10 specially trained NDPs were employed in general practices to take integral responsibility for the pharmaceutical care. They provided a broad range of medication therapy management services both on patient level (e.g. clinical medication review) and practice level (e.g. quality improvement projects). In the control groups, pharmaceutical care was provided as usual by general practitioners and community pharmacists, or as usual plus, when pharmacists were additionally trained in performing medication reviews. RESULTS: Overall, 822 medication‐related hospitalisations were identified among 11 281 high‐risk patients during the intervention period. After adjustment for clustering and potential confounders, the rate ratio of medication‐related hospitalisations in the intervention group compared to usual care was 0.68 (95% confidence interval: 0.57–0.82) and 1.05 (95% confidence interval: 0.73–1.52) compared to usual care plus. No differences in drug burden index or costs were found. CONCLUSIONS: In general practices with an integrated NDP, the rate of medication‐related hospitalisations is lower compared to usual care. No differences with usual care plus were found. John Wiley and Sons Inc. 2019-07-25 2019-10 /pmc/articles/PMC6783584/ /pubmed/31240722 http://dx.doi.org/10.1111/bcp.14041 Text en © 2019 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Sloeserwij, V.M.
Hazen, A.C.M.
Zwart, D.L.M.
Leendertse, A.J.
Poldervaart, J.M.
de Bont, A.A.
de Gier, J.J.
Bouvy, M.L.
de Wit, N.J.
Effects of non‐dispensing pharmacists integrated in general practice on medication‐related hospitalisations
title Effects of non‐dispensing pharmacists integrated in general practice on medication‐related hospitalisations
title_full Effects of non‐dispensing pharmacists integrated in general practice on medication‐related hospitalisations
title_fullStr Effects of non‐dispensing pharmacists integrated in general practice on medication‐related hospitalisations
title_full_unstemmed Effects of non‐dispensing pharmacists integrated in general practice on medication‐related hospitalisations
title_short Effects of non‐dispensing pharmacists integrated in general practice on medication‐related hospitalisations
title_sort effects of non‐dispensing pharmacists integrated in general practice on medication‐related hospitalisations
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783584/
https://www.ncbi.nlm.nih.gov/pubmed/31240722
http://dx.doi.org/10.1111/bcp.14041
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