Age and Ageing 2001; 30: 205-211
© 2001, British Geriatrics Society
Research papers |
Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care
School of Pharmacy, The Robert Gordon University, Aberdeen, UK
1 Albyn Medical Practice, Aberdeen, UK
2 Grampian Primary Care Trust, Woodend Hospital, Aberdeen, UK
3 Department of Medicine for the Elderly, University of Aberdeen, Aberdeen, UK
Abstract
Background: regular medication review has been recommended for those over 75 and those on multiple drug therapy. Pharmacists are a potential source of assistance in reviewing medication. Evidence of the benefits of this process is needed.
Objective: to study the effect of medication review led by a pharmacist on resolution of pharmaceutical care issues, medicine costs, use of health and social services and health-related quality of life.
Design: randomized, controlled trial.
Setting: general medical practices in the Grampian region of Scotland.
Subjects: patients aged at least 65 years, with at least two chronic disease states who were taking at least four prescribed medicines regularly.
Methods: pharmacists reviewed the drug therapy of 332 patients, using information obtained from the practice computer, medical records and patient interviews. In 168 patients, a pharmaceutical care plan was then drawn up and implemented. The 164 control patients continued to receive normal care. All outcome measures were assessed at baseline and after 3 months.
Results: all patients had at least two pharmaceutical care issues at baseline. Half of these were identified from the prescription record, the rest from notes and patient interview. Of all the issues, 21% were resolved by information found in notes and 8.5% by patient interview. General practitioners agreed with 96% of all care issues documented on the care plans in the intervention group. At the time of follow-up, 70% of the remaining care issues had been resolved in the intervention group, while only 14% had been resolved in the control group. There were no changes in medicine costs or health-related quality of life in either group. There were small increases in contacts with health-care professionals and slightly fewer hospital admissions among the intervention group than the control group.
Conclusions: pharmacist-led medication review has the capacity to identify and resolve pharmaceutical care issues and may have some impact on the use of other health services.
Keywords: medication-related problems, medication review, pharmaceutical care, pharmacist
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. M. Triller and R. A. Hamilton Effect of pharmaceutical care services on outcomes for home care patients with heart failure Am. J. Health Syst. Pharm., November 1, 2007; 64(21): 2244 - 2249. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Machado, J. Bajcar, G. C Guzzo, and T. R Einarson Sensitivity of Patient Outcomes to Pharmacist Interventions. Part II: Systematic Review and Meta-Analysis in Hypertension Management Ann. Pharmacother., November 1, 2007; 41(11): 1770 - 1781. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Lenaghan, R. Holland, and A. Brooks Home-based medication review in a high risk elderly population in primary care--the POLYMED randomised controlled trial Age Ageing, May 1, 2007; 36(3): 292 - 297. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Peterson Improving adherence in patients with alcohol dependence: A new role for pharmacists Am. J. Health Syst. Pharm., March 1, 2007; 64(5_Supplement_3): S23 - S29. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A S. Pickard and S.-Y. Hung An Update on Evidence of Clinical Pharmacy Services' Impact on Health-Related Quality of Life Ann. Pharmacother., September 1, 2006; 40(9): 1623 - 1634. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C J Morris, J A Cantrill, A J Avery, and R L Howard Preventing drug related morbidity: a process for facilitating changes in practice. Qual. Saf. Health Care, April 1, 2006; 15(2): 116 - 121. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S Royal, L Smeaton, A J Avery, B Hurwitz, and A Sheikh Interventions in primary care to reduce medication related adverse events and hospital admissions: systematic review and meta-analysis Qual. Saf. Health Care, February 1, 2006; 15(1): 23 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M E. McDermott, B. H Smith, A. M Elliott, C. M Bond, P. C Hannaford, and W A. Chambers The use of medication for chronic pain in primary care, and the potential for intervention by a practice-based pharmacist Fam. Pract., February 1, 2006; 23(1): 46 - 52. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. E. Muijrers, R. P. Grol, J. Sijbrandij, R. Janknegt, and J A. Knottnerus Differences in prescribing between GPs. Impact of the cooperation with pharmacists and impact of visits from pharmaceutical industry representatives Fam. Pract., December 1, 2005; 22(6): 624 - 630. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. van Lankveld, M. Franssen, and A. Stenger Gerontorheumatology: the challenge to meet health-care demands for the elderly with musculoskeletal conditions Rheumatology, April 1, 2005; 44(4): 419 - 422. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Holland, E. Lenaghan, I. Harvey, R. Smith, L. Shepstone, A. Lipp, M. Christou, D. Evans, and C. Hand Does home based medication review keep older people out of hospital? The HOMER randomised controlled trial BMJ, February 5, 2005; 330(7486): 293. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. B Farris, J. M Ganther-Urmie, G. Fang, W. R Doucette, J. M Brooks, D. G Klepser, D. J Fries, and C. L Kuhle Population-Based Medication Reviews: A Descriptive Analysis of the Medication Issues Identified in a Medicare Not-for-Profit Prescription Discount Program Ann. Pharmacother., November 1, 2004; 38(11): 1823 - 1829. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. van Mil, L. T. Westerlund, K. E Hersberger, and M. A Schaefer Drug-Related Problem Classification Systems Ann. Pharmacother., May 1, 2004; 38(5): 859 - 867. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Sellors, J. Kaczorowski, C. Sellors, L. Dolovich, C. Woodward, A. Willan, R. Goeree, R. Cosby, K. Trim, R. Sebaldt, et al. A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients Can. Med. Assoc. J., July 8, 2003; 169(1): 17 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Majumdar and S. B. Soumerai Why most interventions to improve physician prescribing do not seem to work Can. Med. Assoc. J., July 8, 2003; 169(1): 30 - 31. [Full Text] [PDF]
|
|