Abstract
BackgroundThe 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.MethodsCommunity 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.ResultsTwelve 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.ConclusionsThe 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.
Highlights
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 pharmacist-led medication reviews on reducing potential Drug-related problem (DRP) and improving appropriate polymedication [4,5,6,7,8], little is known about the quality of the service provided under routine conditions
We found a high variability between the participating pharmacists (15–100%)
Summary
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 pharmacist-led medication reviews on reducing potential DRPs and improving appropriate polymedication [4,5,6,7,8], little is known about the quality of the service provided under routine conditions. In German long-term care (LTC) facilities for instance, the incidence of adverse drug events was found to be 7.9 per 100 resident-months of which about 60% were judged preventable [10]. This corresponds to studies in LTC facilities in the United States and Canada observing 9.8 adverse drug events per 100 resident-months, 42% considered preventable [9]
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