A Consultant Pharmacist's Role on a Geriatric Assessment Service

Sorrento, Thomas A.; Casselman, Mark; Noonan, Jeannine

doi:10.4140/tcp.n.2007.935

Cited by 4 publications

(6 citation statements)

References 4 publications

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“…Four studies only reported outcomes for caregivers of patients that received comprehensive care and observed that caregivers were satisfied with the program [41,60], experienced an improved ability to cope with the disease of their family member, and experienced less anxiety and caregiver burden [42,60,62]. Although quality sum-scores of these studies were rather low, these studies' findings were rather consistent.…”

Section: Informal Caregiver Related Outcomesmentioning

confidence: 80%

“…Three studies, however, observed that comprehensive care favored usual care in terms of medication compliance, medication appropriateness, antipsychotic and unnecessary drug use, detection of adverse drug reactions, and conditions with omitted drugs [40,70,71]. One study did not compare comprehensive care with usual care but also reported an improvement in medication management due to comprehensive care [62]. Considering the inconsistent findings across studies, there is insufficient evidence for a beneficial effect of comprehensive care on medication use.…”

Section: Functional Statusmentioning

confidence: 90%

“…Patients found the comprehensive care program helpful and user-friendly, and appreciated the holistic approach. They further believed that the program helped them to manage their disease, had improved their health, and made it easier to get access to healthcare services [11,[40][41][42]60,62,64,76,77]. Considering the fact that two studies with relatively high quality sum-scores reported positive effects of comprehensive care on quality of care and satisfaction and that these findings were supported by qualitative findings, there is moderate evidence for a beneficial effect of comprehensive care on quality of care and patient satisfaction.…”

Section: Mortality Mortality Was Evaluated In Six Studiesmentioning

confidence: 99%

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Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review

et al. 2012

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Section: Informal Caregiver Related Outcomesmentioning

confidence: 80%

Section: Functional Statusmentioning

confidence: 90%

Section: Mortality Mortality Was Evaluated In Six Studiesmentioning

confidence: 99%

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Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review

et al. 2012

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“…Enhancing interdisciplinary team approach was the object of 24 studies [ 25 , 34 , 38 – 43 , 48 , 50 , 51 , 53 – 56 , 58 , 59 , 61 – 64 , 67 , 74 , 76 ]. Some of them highlighted the relevance of performing frequent team meetings [ 37 , 43 , 50 , 51 , 55 , 58 , 59 , 76 ]. One particular aspect was including the patient in the team [ 50 , 54 , 56 ].…”

Section: Resultsmentioning

confidence: 99%

“…Supporting the decision-making process and evidence-based practice were included in 19 studies [ 32 , 40 , 41 , 44 , 47 , 48 , 54 – 56 , 59 , 60 , 62 – 64 , 69 , 71 , 75 , 78 , 79 ]. The development, the integration and the use of clinical guidelines, algorithms and decision support tools were the most frequently cited element [ 32 , 40 , 41 , 44 , 47 , 48 , 54 – 56 , 59 , 60 , 62 – 64 , 69 , 71 , 78 , 79 , 81 ]. For example, in a study to evaluate the efficacy of a nurse-care management system designed to improve outcomes in patients with complicated cases of diabetes, Taylor et al (2003) specified that nurse-care managers used treatment algorithms developed by the Kaiser Permanente Medical panels based on national guidelines to titrate patient medications for diabetes, cholesterol, and hypertension [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

What are the effective elements in patient-centered and multimorbidity care? A scoping review

Poitras

Maltais

Bestard-Denommé

et al. 2018

BMC Health Serv Res

159

130

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BackgroundInterventions to improve patient-centered care for persons with multimorbidity are in constant growth. To date, the emphasis has been on two separate kinds of interventions, those based on a patient-centered care approach with persons with chronic disease and the other ones created specifically for persons with multimorbidity. Their effectiveness in primary healthcare is well documented. Currently, none of these interventions have synthesized a patient-centered care approach for care for multimorbidity. The objective of this project is to determine the particular elements of patient-centered interventions and interventions for persons with multimorbidity that are associated with positive health-related outcomes for patients.MethodA scoping review was conducted as the method supports the rapid mapping of the key concepts underpinning a research area and the main sources and types of evidence available. A five-stage approach was adopted: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies; (4) charting the data; and (5) collating, summarizing and reporting results. We searched for interventions for persons with multimorbidity or patient-centered care in primary care. Relevant studies were identified in four systematic reviews (Smith et al. (2012;2016), De Bruin et al. (2012), and Dwamena et al. (2012)). Inductive analysis was performed.ResultsFour systematic reviews and 98 original studies were reviewed and analysed. Elements of interventions can be grouped into three main types and clustered into seven categories of interventions: 1) Supporting decision process and evidence-based practice; 2) Providing patient-centered approaches; 3) Supporting patient self-management; 4) Providing case/care management; 5) Enhancing interdisciplinary team approach; 6) Developing training for healthcare providers; and 7) Integrating information technology. Providing patient-oriented approaches, self-management support interventions and developing training for healthcare providers were the most frequent categories of interventions with the potential to result in positive impact for patients with chronic diseases.ConclusionThis scoping review provides evidence for the adaption of patient-centered interventions for patients with multimorbidity. Findings from this scoping review will inform the development of a toolkit to assist chronic disease prevention and management programs in reorienting patient care.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3213-8) contains supplementary material, which is available to authorized users.

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Assessment of potentially inappropriate medication use among geriatric outpatients in the Slovak Republic

Kosirova,

Urbankova,

Klimas

et al. 2023

BMC Geriatr

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Background Potentially inappropriate medication (PIM) use is a highly prevalent problem among older people, making it challenging to improve patient safety. The aim of this study was to assess the use of PIMs among geriatric outpatients (OUTs) in the Slovak Republic according to the EU(7) PIM list and to identify the differences in PIM prescriptions among general practitioners (GPs), internists (INTs) and geriatricians (GERs). Methods In total, 449 patients (65 years and older) from 4 medical centres who were in the care of GPs (32.5%), INTs (22.7%) or GERs (44.8%) were included in this retrospective analysis. Data were collected from 1.12.2019–31.3.2020. PIMs were identified according to the EU(7) PIM list from patients’ records. PIM prescriptions by GPs, INTs and GERs were assessed. All obtained data were statistically analysed. Results Polypharmacy (68.8% of patients), and PIM use (73% of patients) were observed. The mean number of all prescribed drugs was 6.7 ± 0.2 drugs per day/patient. The mean number of prescribed PIMs was 1.7 ± 0.1 PIMs per day/patient. Drugs from Anatomical Therapeutic Chemical (ATC) classes C, N and A accounted for the greatest number of PIMs. Significantly higher numbers of prescribed drugs as well as PIMs were prescribed by GPs than INTs or GERs. There were 4.2 times higher odds of being prescribed PIMs by GPs than by GERs (p < 0.001). Conclusions Polypharmacy and overprescription of PIMs were identified among geriatric patients in our study. We found a positive relationship between the number of prescribed drugs and PIMs. The lowest odds of being prescribed PIMs were observed among those who were in the care of a geriatrician. The absence of geriatricians and lack of information about PIMs among general practitioners leads to high rates of polypharmacy and overuse of potentially inappropriate medications in geriatric patients in the Slovak Republic.

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A Consultant Pharmacist's Role on a Geriatric Assessment Service

Abstract: The GAS program provided assistance to primary care providers caring for community-dwelling, at-risk seniors, resulting in improved pharmaceutical care, reduction in caregiver strain, and positive patient satisfaction.

Cited by 4 publications

References 4 publications

Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review

Comprehensive care programs for patients with multiple chronic conditions: A systematic literature review

What are the effective elements in patient-centered and multimorbidity care? A scoping review

Assessment of potentially inappropriate medication use among geriatric outpatients in the Slovak Republic

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