Retrospective evaluation of medication appropriateness and clinical pharmacist drug therapy recommendations for home-based primary care veterans

Davis, Ryan G.; Hepfinger, Charley A.; Sauer, Karen Ann; Wilhardt, Michelle S.

doi:10.1016/j.amjopharm.2007.03.003

Cited by 34 publications

(22 citation statements)

References 19 publications

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“…It also supports previous research exploring the perspectives of a broad range of Australian pharmacists (including accredited pharmacists), which reported strongest support for an expanded prescribing role in hypertension management among a select range of chronic conditions . Furthermore, the prescribing interventions described by these pharmacists were assessed as being largely clinically appropriate by doctors themselves, in line with findings from other studies exploring the appropriateness and/or uptake of pharmacist recommendations in other contexts, for example in older patients, management of lipid disorders and in high‐risk medication, such as thromboprophylaxis in surgical patients . In the latter study, there was no difference in the appropriateness of treatment prescribed by pharmacists compared with resident medical officers, but prescribing by pharmacists was shown to contain fewer clinically significant omissions and fewer prescribing errors .…”

Section: Discussionsupporting

confidence: 85%

Exploring the potential for pharmacist prescribing in the management of hypertension in primary care: an Australian survey

Bajorek

Krass

2017

Pharmacy Practice and Res

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Background The management of hypertension, particularly medicines use, remains suboptimal and pharmacist‐delivered models of care may assist clinicians in this regard. Aim The primary objective of this study was to explore the potential for pharmacists to make treatment recommendations and prescribing decisions for patients with hypertension. Method Accredited (medicines review) pharmacists working in the primary care setting within the Sydney metropolitan area (NSW, Australia) were recruited. Pharmacists completed a scenario‐based survey that asked them to demonstrate a simulated prescribing function in the management of 6 patient scenarios. The management of the scenarios was assessed from the pharmacists’ perspective (i.e. usefulness of prescribing, confidence in prescribing) and by an expert clinical panel (i.e. clinical appropriateness). Results Thirty pharmacists (27.4 ± 10.7 years in practice) participated. Most pharmacists indicated that a prescribing function would be useful within their scope of practice and that they would be confident in executing this as an intervention. The expert clinical panel rated the vast majority of recommendations by pharmacists to be appropriate. Ratings for usefulness of, confidence in and appropriateness of the prescribing recommendations were lowest for the 2 scenarios depicting more complex cases; here the level of agreement among the expert panel was also poor (κ ≤ 0.15). Recommendations relating to processes for assessing patients were rated relatively lower, particularly for the complex scenarios. Conclusion Accredited pharmacists have the capacity and potential for a prescribing function to help optimise hypertension management. Simulated prescribing interventions undertaken by accredited pharmacists were assessed as clinically appropriate by medical clinicians.

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Section: Discussionsupporting

confidence: 85%

Exploring the potential for pharmacist prescribing in the management of hypertension in primary care: an Australian survey

Bajorek

Krass

2017

Pharmacy Practice and Res

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“…15 One report that used the MAI retrospectively, similar to our study, showed that medication review significantly reduced patient MAI scores from baseline. 34 However, MAI scores between the studies may differ depending upon the setting, number of medications, types of patients and GPs, quality of prescribing, and clinical judgment of the raters; hence, the effects of the interventions must be interpreted within their own context. 35 In our study, improvement in the quality of prescribing was also observed in patients for whom outcome data were available (almost 38%).…”

Section: Discussionmentioning

confidence: 99%

Retrospective Evaluation of Home Medicines Review by Pharmacists in Older Australian Patients Using the Medication Appropriateness Index

2010

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The study demonstrates that the provision of medication reviews by accredited pharmacists can improve the appropriateness of prescribing as demonstrated by the change in MAI score and, hence, has the potential to improve patient outcomes. Pharmacists who perform medication reviews could also consider including the systematic approach of applying the MAI to assist in optimizing prescribing in older people.

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“…Pharmacist's recommendations to primary care providers and nurses involved drug initiation/discontinuation; laboratory monitoring; dosage adjustment; as well as monitoring for medication adherence; efficacy and adverse events [40].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and predictors of potentially inappropriate medications among home care elderly patients in Qatar

2015

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Retrospective evaluation of medication appropriateness and clinical pharmacist drug therapy recommendations for home-based primary care veterans

Cited by 34 publications

References 19 publications

Exploring the potential for pharmacist prescribing in the management of hypertension in primary care: an Australian survey

Exploring the potential for pharmacist prescribing in the management of hypertension in primary care: an Australian survey

Retrospective Evaluation of Home Medicines Review by Pharmacists in Older Australian Patients Using the Medication Appropriateness Index

Prevalence and predictors of potentially inappropriate medications among home care elderly patients in Qatar

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