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Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study

BACKGROUND: Polypharmacy is highly prevalent in older patients with multimorbidity and is associated with increased risk of adverse drug events. This pilot study investigated the added value of a bedside medication review with cognitive and depression screening by a clinical pharmacist to identify p...

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Autores principales: Mertens, Veerle, Jacobs, Leen, Knops, Nicole, Alemzadeh, Seyedeh Malihe, Vandeven, Kay, Swartenbroekx, Jo, Moorkens, Greta, Vandewoude, Maurits
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9586415/
https://www.ncbi.nlm.nih.gov/pubmed/36269748
http://dx.doi.org/10.1371/journal.pone.0276402
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author Mertens, Veerle
Jacobs, Leen
Knops, Nicole
Alemzadeh, Seyedeh Malihe
Vandeven, Kay
Swartenbroekx, Jo
Moorkens, Greta
Vandewoude, Maurits
author_facet Mertens, Veerle
Jacobs, Leen
Knops, Nicole
Alemzadeh, Seyedeh Malihe
Vandeven, Kay
Swartenbroekx, Jo
Moorkens, Greta
Vandewoude, Maurits
author_sort Mertens, Veerle
collection PubMed
description BACKGROUND: Polypharmacy is highly prevalent in older patients with multimorbidity and is associated with increased risk of adverse drug events. This pilot study investigated the added value of a bedside medication review with cognitive and depression screening by a clinical pharmacist to identify potentially inappropriate medications (PIMs) and medication use issues in older patients with polypharmacy. METHODS AND RESULTS: In the period from September 2018 to March 2019, a clinical pharmacist took part in the comprehensive geriatric assessment of 37 older patients hospitalized at Antwerp University Hospital and conducted a medication review consisting of a record review, a bedside interview questionnaire covering medication use, evaluation of cognitive function (abbreviated MMSE), depression (GDS-4), and systematic check for possible PIMs (STOPP/START criteria). Patients were 83±4 years old and on a median of 12 home medications (range 5–20). The clinical pharmacist formulated an average of 7.7 recommendations to optimize medication use per patient, of which 89.9% were considered clinically relevant by the geriatrician. Only 2 out of 286 PIMs were discovered during routine electronic validation of medication prescriptions. Supervision of medication intake was absent in 75% of cognitively impaired patients, but advice to do so was implemented in 86.4% of cases. The multidisciplinary geriatric advice was communicated to the treating physician, who fully implemented 33.8% of the recommendations. CONCLUSIONS: Bedside medication review with cognitive and depression screening by a clinical pharmacist is useful to discover polypharmacy related problems and medication intake issues in a population of geriatric patients. Systematic screening for cognitive impairment and depression are needed to detect patients in need of support for correct medication use and therapy compliance.
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spelling pubmed-95864152022-10-22 Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study Mertens, Veerle Jacobs, Leen Knops, Nicole Alemzadeh, Seyedeh Malihe Vandeven, Kay Swartenbroekx, Jo Moorkens, Greta Vandewoude, Maurits PLoS One Research Article BACKGROUND: Polypharmacy is highly prevalent in older patients with multimorbidity and is associated with increased risk of adverse drug events. This pilot study investigated the added value of a bedside medication review with cognitive and depression screening by a clinical pharmacist to identify potentially inappropriate medications (PIMs) and medication use issues in older patients with polypharmacy. METHODS AND RESULTS: In the period from September 2018 to March 2019, a clinical pharmacist took part in the comprehensive geriatric assessment of 37 older patients hospitalized at Antwerp University Hospital and conducted a medication review consisting of a record review, a bedside interview questionnaire covering medication use, evaluation of cognitive function (abbreviated MMSE), depression (GDS-4), and systematic check for possible PIMs (STOPP/START criteria). Patients were 83±4 years old and on a median of 12 home medications (range 5–20). The clinical pharmacist formulated an average of 7.7 recommendations to optimize medication use per patient, of which 89.9% were considered clinically relevant by the geriatrician. Only 2 out of 286 PIMs were discovered during routine electronic validation of medication prescriptions. Supervision of medication intake was absent in 75% of cognitively impaired patients, but advice to do so was implemented in 86.4% of cases. The multidisciplinary geriatric advice was communicated to the treating physician, who fully implemented 33.8% of the recommendations. CONCLUSIONS: Bedside medication review with cognitive and depression screening by a clinical pharmacist is useful to discover polypharmacy related problems and medication intake issues in a population of geriatric patients. Systematic screening for cognitive impairment and depression are needed to detect patients in need of support for correct medication use and therapy compliance. Public Library of Science 2022-10-21 /pmc/articles/PMC9586415/ /pubmed/36269748 http://dx.doi.org/10.1371/journal.pone.0276402 Text en © 2022 Mertens et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Mertens, Veerle
Jacobs, Leen
Knops, Nicole
Alemzadeh, Seyedeh Malihe
Vandeven, Kay
Swartenbroekx, Jo
Moorkens, Greta
Vandewoude, Maurits
Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study
title Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study
title_full Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study
title_fullStr Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study
title_full_unstemmed Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study
title_short Bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: A pilot study
title_sort bedside medication review with cognitive and depression screening by a clinical pharmacist as part of a comprehensive geriatric assessment in hospitalized older patients with polypharmacy: a pilot study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9586415/
https://www.ncbi.nlm.nih.gov/pubmed/36269748
http://dx.doi.org/10.1371/journal.pone.0276402
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