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Medication review in nursing home residents by clinical pharmacist and its impact on the quality of the prescriptions Volume 39, issue 2, Juin 2020

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Authors
1 Service de pharmacie, ISoSL, Hôpital Valdor, Liège, Belgique
2 Service de pharmacie, CHR Verviers East Belgium, Verviers, Belgique
3 Assistance pharmaco-thérapeutique, Cliniques universitaires de Bruxelles, Bruxelles, Belgique
* Correspondance

Inappropriate prescriptions are common among elderly people living in nursing homes and can have severe health consequences. The medication review is a structured assessment of the patient‘s medication with the aim of optimizing medicines use and improving health outcomes. This entails detecting drug related problems and recommending interventions. This study analyzes the impact of pharmaceutical interventions performed by a clinical pharmacist during medication review on the number of inappropriate medication prescriptions in nursing homes. Methods.373 patients from three Belgian nursing homes were included (n = 373) in this ten months interventional study. Data were collected during two different periods: before medication review (J0) and two months after (J60). The quality of the drug treatment was measured through different indicators: number of inappropriate prescriptions (STOPP/START.v2 criteria), number of drug interactions, number of contraindicated drugs in case of renal insufficiency and drug dosing adjustment errors, therapeutic drug monitoring, drug costs. Results.Medication review decreases the number of inappropriate prescriptions (-11,7%; p< 0,001), drug interactions (- 37,6%; p< 0,001) and increases drug monitoring (+8,6%; p< 0,001). An annual saving of 52 EUR per resident was generated. Conclusion.This study shows that medication review performed by clinical pharmacist in collaboration with physicians and nurses decreases significantly the number of inappropriate prescribings and drug interactions and while improving drug monitoring and generating savings for the residents and the society.

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