Evaluation of a safe medication strategy intervention for people with dementia with an unplanned admission: Results from the Safe Medication Strategy Dementia Study

Kable, Ashley; Hullick, Carolyn; Palazzi, Kerrin; Oldmeadow, Christopher; Searles, Andrew; Ling, Rod; Pond, Dimity; Fullerton, Anne; Fraser, Samantha; Bruce, Remia; Murdoch, Wendy; Attia, John

doi:10.1111/ajag.12877

Cited by 2 publications

(3 citation statements)

References 18 publications

(35 reference statements)

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“…Patients were included in the study if they were admitted from home or a Residential Aged Care Facility (RACF), and each participant was only recruited into the study once. Additional detail about participant eligibility is provided in a separate publication [18].…”

Section: Study Participantsmentioning

confidence: 99%

“…The intervention was an evidence-based bundle of care [18] and comprised seven strategies delivered after admission and prior to discharge by the study pharmacist (see Figure 1). In this study, the delivery of medication review and reconciliation incorporated the following activities.…”

Section: The Interventionmentioning

confidence: 99%

“…The intervention was an evidence-based bundle of care including pharmacist medication reconciliation and review and is described in detail in Figure 1. The effects of the intervention on the primary outcomes are reported separately [18].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the Effect of a Safe Medication Strategy on Potentially Inappropriate Medications, Polypharmacy and Anticholinergic Burden for People with Dementia: An Intervention Study

Kable,

Fraser,

Fullerton

et al. 2023

Healthcare

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People with dementia (PWD) are at risk for medication-related harm due to their impaired cognition and frequently being prescribed many medications. This study evaluated a medication safety intervention (including pharmacist medication reconciliation and review) for PWD during an unplanned admission to hospital. This article reports the effect of the intervention on polypharmacy, potentially inappropriate medications (PIMs), and anticholinergic burden scores for PWD. A pre-post design using an intervention site and a control site was conducted in 2017–2019, in a regional area in New South Wales, Australia. Polypharmacy, PIMs, and anticholinergic burden were measured at admission, discharge, and three months after discharge. There were 628 participants including 289 at the control site and 339 at the intervention site. Polypharmacy was 95% at admission and 90% at discharge. PIMs at admission were 95–98% across timepoints and decreased significantly at discharge. The mean anticholinergic score decreased significantly between admission (2.40–3.15) and discharge (2.01–2.57). Reduced PIMs at discharge were correlated with reduced anticholinergic burden (rho = 0.48–0.55, p < 0.001). No significant differences were identified between the study and control sites for Polypharmacy, PIMs, and anticholinergic burden rates and scores. High rates of polypharmacy and PIMs in this study indicate a study population with multiple comorbidities. This intervention was feasible to implement but was limited due to difficulty recruiting participants and deaths during the study. Future multisite studies should be designed to recruit larger study samples to evaluate interventions for improving medication safety for PWD and improve outcomes for these vulnerable people.

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Section: Study Participantsmentioning

confidence: 99%

Section: The Interventionmentioning

confidence: 99%

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Evaluation of the Effect of a Safe Medication Strategy on Potentially Inappropriate Medications, Polypharmacy and Anticholinergic Burden for People with Dementia: An Intervention Study

Kable,

Fraser,

Fullerton

et al. 2023

Healthcare

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Systematic literature review of the impact of psychiatric pharmacists

Ho,

Roberts,

Payne

et al. 2024

Mental Health Clinician

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Introduction Pharmacists focusing on psychotropic medication management and practicing across a wide variety of healthcare settings have significantly improved patient-level outcomes. The Systematic Literature Review Committee of the American Association of Psychiatric Pharmacists was tasked with compiling a comprehensive database of primary literature highlighting the impact of psychiatric pharmacists on patient-level outcomes. Methods A systematic search of literature published from January 1, 1961, to December 31, 2022, was conducted using PubMed and search terms based on a prior American Association of Psychiatric Pharmacists literature review. Publications describing patient-level outcome results associated with pharmacist provision of care in psychiatric/neurologic settings and/or in relation to psychotropic medications were included. The search excluded articles for which there was no pharmacist intervention, no psychiatric disorder treatment, no clinical outcomes, no original research, no access to full text, and/or no English-language version. Results A total of 4270 articles were reviewed via PubMed, with 4072 articles excluded based on title, abstract, and/or full text in the initial pass and 208 articles selected for inclusion. A secondary full-text review excluded 11 additional articles, and 5 excluded articles were ultimately included based on a secondary review, for a final total of 202 articles meeting the inclusion criteria. A comprehensive database of these articles was compiled, including details on their study designs and outcomes. Discussion The articles included in the final database had a wide range of heterogeneity. While the overall impact of psychiatric pharmacists was positive, the study variability highlights the need for future publications to have more consistent, standardized outcomes with stronger study designs.

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Evaluation of a safe medication strategy intervention for people with dementia with an unplanned admission: Results from the Safe Medication Strategy Dementia Study

Cited by 2 publications

References 18 publications

Evaluation of the Effect of a Safe Medication Strategy on Potentially Inappropriate Medications, Polypharmacy and Anticholinergic Burden for People with Dementia: An Intervention Study

Evaluation of the Effect of a Safe Medication Strategy on Potentially Inappropriate Medications, Polypharmacy and Anticholinergic Burden for People with Dementia: An Intervention Study

Systematic literature review of the impact of psychiatric pharmacists

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