Appropriateness of Prescribing among Elderly Patients in a Dutch Residential Home

Stuijt, Clementine C. M.; Franssen, Eric J. F.; Egberts, Toine C. G.; Hudson, Steve

doi:10.2165/0002512-200825110-00005

Cited by 77 publications

(34 citation statements)

References 23 publications

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“…Our results are similar to those obtained by other authors in reference to the degree of acceptation of the pharmacist's proposed changes (around 70%) and the kind of drugs usually used in DRPs, the alimentary tract and metabolism, Cardiovascular and nervous system being the main classes involved in the interventions 2 11…”

Section: Discussionsupporting

confidence: 91%

“…The MAI score has showed that interventions have produced an improvement in the pharmacological profile of our patients; however, we avoid comparing the score with other scores as it is known that variations in scores depend on the context 2 3…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the optimisation of drug therapy has become an essential part of healthcare. Prescription for this population is complex, involving different clinicians (primary care and secondary care); therefore, inappropriate drug treatments have been found to be a common problem in these settings 2 3. The involvement of pharmacists (consultant or community pharmacists) in nursing homes, through the review of treatments and interventions/recommendations, has shown that their work could be beneficial.…”

Section: Introductionmentioning

confidence: 99%

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Improvement of pharmacological treatments in nursing homes: medication review by consultant pharmacists

Mestres¹,

Hernández²,

Llagostera³

et al. 2015

Eur J Hosp Pharm

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Objectives To establish a medication review programme in geriatric patients in nursing homes. Methods 70 nursing homes, attended by 8 healthcare teams; two consultant pharmacists provide training and support. Prospective study, conducted between August and December 2013, consisting in patients medication profile review, using an algorithm developed by the Pharmacy Department. Drug-related problems (DRP) were communicated to physicians and documented using the Pharmaceutical Care Network Europe scheme. Medication appropriateness index (MAI) score was calculated before and after the pharmacist's interventions.Results Medication profiles of 127 patients (mean age 84 years) were reviewed. 424 DRP were detected, the majority related to potential adverse drug events. Pharmacists' interventions/recommendations were made mainly at prescription level. Lack of indication for the drug prescribed in the clinical record was a recurrent problem, thus indicating a somewhat poor quality in these records. Potentially inappropriate drug prescription was also a common problem (17.6%). Cardiovascular, alimentary tract and metabolism and nervous system drugs were those with more DRP. Degree of acceptance of interventions was 80%. The principal cause of nonacceptance was when the drug has been prescribed by a specialist. Number of drugs per patient dropped from 10.3 to 9.5, and the mean MAI score dropped from 5.4 to 1.3. Conclusions The incorporation of consultant pharmacists at nursing home level has led us to know the quality of prescription and the DRP. We have established a multidisciplinary team that works for the improvement of drug use.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Improvement of pharmacological treatments in nursing homes: medication review by consultant pharmacists

Mestres¹,

Hernández²,

Llagostera³

et al. 2015

Eur J Hosp Pharm

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“…These patients were recruited for a medication review investigation throughout a period of 12 months over the period April 2003 until April 2004 and described elsewhere [11]. Briefly, those persons took an average of five regularly scheduled drugs making a total of at least 80 medications.…”

Section: Setting and Study Populationmentioning

confidence: 99%

Reliability of the medication appropriateness index in Dutch residential home

et al. 2009

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“…With studies confirming the benefits of pharmacy-based patient care services to promote appropriate, safe and effective use of medications among elderly patients, expanding the institutional APPE sites to include Long-Term Care (LTC) facilities seemed a sensible solution to address capacity issues [8-14]. However, including LTC facilities as APPE sites remained problematic since the majority were serviced by off-site community pharmacists offering medication dispensing services remotely, with on-site time limited to once a week for patient care services.…”

Section: Introductionmentioning

confidence: 99%

A demonstration study comparing “role-emergent” versus “role-established” pharmacy clinical placement experiences in long-term care facilities

Kassam

Kwong²,

Collins

2013

BMC Med Educ

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BackgroundIncreasing challenges to recruit hospital sites with full-time on-site pharmacy preceptors for institutional-based Advanced Pharmacy Practice Experiences (APPE) has made it necessary to consider alternate experiential models. Sites with on-site discipline specific preceptors to supervise students have typically been referred to in the literature as “role-established” sites. In British Columbia, long-term care (LTC) facilities offered a unique opportunity to address placement capacity issues. However, since the majority of these facilities are serviced by off-site community pharmacists, this study was undertaken to explore the viability of supervising pharmacy students remotely – a model referred to in the literature as “role-emergent” placements. This paper’s objectives are to discuss pharmacy preceptors’ and LTC non-pharmacist staff experiences with this model.MethodsThe study consisted of three phases: (1) the development phase which included delivery of a training program to create a pool of potential LTC preceptors, (2) an evaluation phase to test the viability of the LTC role-emergent model with seven pharmacists (two role-established and five role-emergent) together with their LTC staff, and (3) expansion of LTC role-emergent sites to build capacity. Both qualitative and quantitative methods were used to obtain feedback from pharmacists and staff and t-tests and Mann–Whitney U tests were used to examine equivalency of survey outcomes from staff representing both models.ResultsThe 76 pharmacists who completed the training program survey rated the modules as “largely” meeting their learning needs. All five role-emergent pharmacists and 29 LTC participating staff reported positive experiences with the pharmacy preceptor-student-staff collaboration. Preceptors reported that having students work side-by-side with facility staff promoted inter-professional collaboration. The staff viewed students’ presence as a mutually beneficial experience, suggesting that the students’ presence had enabled them to deliver better care to the residents. As a direct result of the study findings, the annual role-emergent placement capacity was increased to over 45 by the end of the study.ConclusionsThis study demonstrated that role-emergent LTC facilities were not only viable for quality institutional APPEs but also provided more available sites, greater student placement capacity, and more trained pharmacy preceptors than could be achieved in role-established facilities.

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Appropriateness of Prescribing among Elderly Patients in a Dutch Residential Home

Cited by 77 publications

References 23 publications

Improvement of pharmacological treatments in nursing homes: medication review by consultant pharmacists

Improvement of pharmacological treatments in nursing homes: medication review by consultant pharmacists

Reliability of the medication appropriateness index in Dutch residential home

A demonstration study comparing “role-emergent” versus “role-established” pharmacy clinical placement experiences in long-term care facilities

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