Impact of a pharmacist-administered deprescribing intervention on nursing home residents: a randomized controlled trial

Balsom, Cathy; Pittman, Nicole; King, Renee; Kelly, Debbie

doi:10.1007/s11096-020-01073-6

Cited by 38 publications

(64 citation statements)

References 18 publications

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“…Studies were conducted in Australia, Canada, Japan, and Northern Ireland. These studies support the addition of a pharmacist or pharmacist medication review, as it can reduce the number of unnecessary and potential harmful medications taken by residents [74][75][76][77][78][79] and improve medication administration practices [78,80]. Several other outcomes were evaluated, including falls, sleep status, adverse events/reactions, ED presentation rates, quality of life, hospitalizations, and mortality.…”

Section: Plos Onementioning

confidence: 97%

“…Seven studies evaluated medication review and/or the addition of a pharmacist to LTCH. Interventions included an in-depth medication review by pharmacy students (n = 22) [74], review of residents' medications by a clinical pharmacist (n = 90) [75], pharmacist visit once per week (n = 32) [76], the implementation of a residential pharmacist position (n = 74) [77], a part-time pharmacist employed (n = 58) [78], the Fleetwood Northern Ireland model of pharmaceutical care which included a monthly visit by a pharmacist (n = 173) [79], and the addition of a clinical pharmacist applied simplification guide (n = 99) [80]. Comparisons were typically usual or standard care (median: n = 43, range: 23 to 897).…”

Section: Plos Onementioning

confidence: 99%

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Models of provider care in long-term care: A rapid scoping review

et al. 2021

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Introduction One of the current challenges in long-term care homes (LTCH) is to identify the optimal model of care, which may include specialty physicians, nursing staff, person support workers, among others. There is currently no consensus on the complement or scope of care delivered by these providers, nor is there a repository of studies that evaluate the various models of care. We conducted a rapid scoping review to identify and map what care provider models and interventions in LTCH have been evaluated to improve quality of life, quality of care, and health outcomes of residents. Methods We conducted this review over 10-weeks of English language, peer-reviewed studies published from 2010 onward. Search strategies for databases (e.g., MEDLINE) were run on July 9, 2020. Studies that evaluated models of provider care (e.g., direct patient care), or interventions delivered to facility, staff, and residents of LTCH were included. Study selection was performed independently, in duplicate. Mapping was performed by two reviewers, and data were extracted by one reviewer, with partial verification by a second reviewer. Results A total of 7,574 citations were screened based on the title/abstract, 836 were reviewed at full text, and 366 studies were included. Studies were classified according to two main categories: healthcare service delivery (n = 92) and implementation strategies (n = 274). The condition/ focus of the intervention was used to further classify the interventions into subcategories. The complex nature of the interventions may have led to a study being classified in more than one category/subcategory. Conclusion Many healthcare service interventions have been evaluated in the literature in the last decade. Well represented interventions (e.g., dementia care, exercise/mobility, optimal/appropriate medication) may present opportunities for future systematic reviews. Areas with less research (e.g., hearing care, vision care, foot care) have the potential to have an impact on balance, falls, subsequent acute care hospitalization.

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Section: Plos Onementioning

confidence: 97%

Section: Plos Onementioning

confidence: 99%

Models of provider care in long-term care: A rapid scoping review

et al. 2021

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“…A study by Forsetlund et al have shown that interventions, including education and pharmacist‐led medication review, could lessen harmful medications under certain circumstances 39 . A recent study conducted in Canada suggested that pharmacist‐led deprescribing‐focused medication review minimised unnecessary and potentially harmful medications 40 . There have been several tools to support HCPs to deprescribe harmful or unwanted medications with certainty 41 .…”

Section: Discussionmentioning

confidence: 99%

“…39 A recent study conducted in Canada suggested that pharmacist-led deprescribing-focused medication review minimised unnecessary and potentially harmful medications. 40 There have been several tools to support HCPs to deprescribe harmful or unwanted medications with certainty. 41 However, it is unknown as to which tools are more important to effectively deprescribing and improving patient outcomes particular to the Ethiopian context.…”

Section: Ta B L Ementioning

confidence: 99%

Deprescribing practice in a resource‐limited setting: Healthcare providers’ insights

et al. 2021

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Aims Inappropriate polypharmacy poses risks of adverse drug events, high healthcare costs and mortality. Deprescribing could minimise inappropriate polypharmacy and the consequences thereof. The aim of this study was to evaluate healthcare providers’ (HCPs’) attitudes toward and experiences with deprescribing practice in Ethiopia. Methods We conducted an institution‐based cross‐sectional survey among HCPs at the University of Gondar Comprehensive Specialized Hospital, Ethiopia. We used a validated questionnaire developed by Linsky et al. The tool included questions that explore medication characteristics, current patient clinical factors, predictions of future health states, patients’ resources to manage their own health and education and experience. One‐way ANOVA was used to test the association between sociodemographic variables and their perception of deprescribing decisions. Results Of 85 HCPs approached, about 82 HCPs completed the survey, giving a response rate of 96.5%. Most of the participants (n = 73, 89%) have scored less than 1.5 points showing they are reluctant to proactively deprescribe. Physicians seem to be affected by the significant physical health conditions (mean = 1.68) and clinical endpoint like blood pressure (mean = 1.5) to make deprescribing decisions. According to the post hoc analysis of one‐way ANOVA, clinical pharmacists seemed to have a better attitude toward deprescribing decisions compared with physicians (P = .025). Conclusion HCPs’ decision to discontinue a medication could be multifactorial. Physicians could be influenced by physical health condition and clinical endpoints for deprescribing decision. Future studies should emphasise on barriers and facilitators to deprescribing practice specific to the context in Ethiopia.

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“…A study by Forsetlund et al have shown that interventions, including education and pharmacist-led medication review could lessen harmful medications under certain circumstances (29). A recent study conducted in Canada suggested that pharmacist-led deprescribing focused medication review minimised unnecessary and potentially harmful medications (30). There have been several tools to support HCPs to assuredly deprescribe harmful or unwanted medications (31).…”

Section: Discussionmentioning

confidence: 99%

Deprescribing practice in a resource-limited setting: Healthcare providers’ insights

Tegegn

Gebresillassie

Erku

et al. 2020

Preprint

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Aims: Inappropriate polypharmacy poses adverse drug events, mortality, and high healthcare costs. Deprescribing could minimise inappropriate polypharmacy and the consequence thereof. This study aims to evaluate healthcare providers' (HCPs) attitudes toward, and experiences with the deprescribing practice. Methods: An institution-based cross-sectional study was conducted among HCPs at the University of Gondar Referral Hospital, Ethiopia. Perception of HCPs on deprescribing was measured by Linsky et al. validated tool. This tool has five dimensions that could affect HCPs' decision to discontinue medications intentionally. One-way ANOVA was used to test the association between socio-demographic variables and their perception of deprescribing decisions. Results: Of 85 HCPs approached, about 82 HCPs with a 96.5% response rate were included in the final analysis of this study. Most HCPs (87%) were less likely or not at all to be affected by a strong relationship between HCPs and their patients to make a deprescribing decision. However, HCPs believed that formal education, significant physical health conditions, objective response to the clinical endpoint of the medication (e.g., blood pressure), and on-the-job experience profoundly influenced them to decide on deprescribing. According to the post-hoc analysis of one-way ANOVA, clinical pharmacists seemed to have a better attitude toward deprescribing decisions compared to physicians. (p = 0.025). Conclusion: HCPs' decision to discontinue a medication could be multifactorial, and HCPs could be influenced by education level and their experience to discontinue a medication intentionally. A therapy-specific deprescribing algorithm, multidisciplinary collaboration, and continuous education development should be instituted to guide HCPs in the deprescribing decision process.

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Impact of a pharmacist-administered deprescribing intervention on nursing home residents: a randomized controlled trial

Cited by 38 publications

References 18 publications

Models of provider care in long-term care: A rapid scoping review

Models of provider care in long-term care: A rapid scoping review

Deprescribing practice in a resource‐limited setting: Healthcare providers’ insights

Deprescribing practice in a resource-limited setting: Healthcare providers’ insights

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