Clinical Pharmacists Prescribing Drug Therapy in a Geriatric Setting: Outcome of a Trial

Abstract

Clinical pharmacists, under the supervision of a family practitioner physician, assumed responsibility for drug management of geriatric patients in a Los Angeles skilled nursing facility. In a quasi-experimental, pretest-post-test control group design, outcome criteria were measured. Compared with the control group which received traditional patient care, the prescribing clinical pharmacists' group had a significantly lower number of deaths (P = 0.05), a significantly higher number of patients being discharged to lower levels of care (P = 0.03), and a significantly lower average number of drugs per patient (P = 0.04). The lower number of patients hospitalized approached significance (P = 0.06) in the prescribing clinical pharmacists' group. The practice of having clinical pharmacists prescribe drug therapy and render general care, under the supervision of a physician, has the potential for saving the health care system approximately $70,000 per year per 100 skilled nursing facility beds.

Medication use in nursing homes for elderly people

“…Physician acceptance of pharmacist recommendations is high and has been reported as being between 60% and 81% (Dyer et al, 1984;Miller et al, 1993). Thompson et al (1984) described a situation where clinical pharmacists assumed total responsibility for the drug management of a group of geriatric patients in a nursing home, comparing this group with a control group who received traditional patient care. The pharmacist group had improved mortality and morbidity and their patients were on approximately two fewer drugs.…”

Clinical medication review by a pharmacist of patients on repeat prescriptions in general practice: a randomised controlled trial

“…The difference in numbers is nonetheless intriguing and it would be important to look for differences in mortality in a larger study, especially as other studies in nursing homes have detected a reduction in mortality resulting from pharmacist intervention. 64,65 If a pharmacist was actually able to reduce mortality in 608 patients by ten in 1 year, this would imply a number-needed-to-treat per annum of 60 to prevent one death -a much more effective intervention than the treatment of hypertension.…”

Revisão dos estudos de intervenção do farmacêutico no uso de medicamentos por pacientes idosos

“…Os estudos analisados reforçam a idéia de que a intervenção do farmacêutico aumenta a adesão dos pacientes idosos a seus regimes terapêuticos, e pode promover redução de custos hospitalares, ao reduzir o número de prescrições, de internações e de medicamentos associados a RAMs (Grymonpre et al, 1994;Phillips & Carr-Lopez, 1990;Thompson et al, 1984;Walker & Martin, 1986). Em particular, Gehres (1986) relata a experiência de um serviço pago de acompanhamento de farmacêuticos a idosos, cuja atenção permitiu a auto-administração de medicamentos e a possibilidade de vida junto a instituições de apoio à saúde de menor complexidade e, portanto, mais baratas.…”