Large scale implementation of clinical medication reviews in Dutch community pharmacies: drug-related problems and interventions

Abstract

This study is the largest analysis of pharmacists-initiated CMRs in the Netherlands to date. The findings demonstrate the potential to reduce medication-related errors through pharmacist involvements in complex pharmacotherapy and the positive impact on the quality of drug therapy through making necessary medication changes. The data also support the need for large-scale implementation of pharmacists-initiated CMRs in the presence of proper training programmes.

A qualitative study of community pharmacists’ opinions on the provision of osteoporosis disease state management services in Malaysia

“…It is a validated tool for pharmacists’ risk assessment for osteoporosis, and thus is useful to educate patients about this condition. Community pharmacists also can play a more significant clinical role in identifying drug-induced osteoporosis, such as in corticosteroid users [37, 38]. Our participants also supported the role of community pharmacy in the management of diagnosed osteoporosis through counseling to optimize adherence to prescribed osteoporosis medicines and lifestyle changes.…”

Evaluation of drug‐related problems in older polypharmacy primary care patients

“…A DRP is defined as any undesirable event experienced by a patient, involving or suspected of involving drug therapy and actually or potentially interfering with the desired patient outcome . Identifying and reducing DRPs is possible through medication reviews conducted by pharmacists . In the United Kingdom, United States, Australia, and the Netherlands, the term clinical medication review (CMR) is increasingly used and defined as a face‐to‐face cooperation between the pharmacist and/or general practitioner (GP) and the patient to systematically review a patient's medication and conditions .…”

Drug‐related problems identified during medication review before and after the introduction of a clinical decision support system

“…Pharmacists were trained to document the results of the CMRs in the software program . The following characteristics were documented: date of the CMR, name and ATC‐code (Anatomical Therapeutic Chemical classification) of the drug(s) involved, DRP type, type of recommendation (eg recommendation to add a drug) proposed by the pharmacist and type of implemented recommendation (eg the drug was added).…”

“…Secondary outcome measurements were type of DRPs, type of implemented recommendations and prevalence of the potential DRPs generated by CDSS. The classification of DRPs was adapted from Hepler and Strand and is described in the national guidelines …”

“…1 A clinical medication review (CMR), consisting of a structured assessment of the pharmacotherapy including a patient interview, is an important instrument to identify and resolve DRPs. [1][2][3][4][5] This is a time-consuming process. 6 Given the expected increase in older people with polypharmacy, 7,8 the amount of medication reviews will increase substantially in the near future.…”