Regardless of community pharmacists' contributions to interventions, medication review interventions seem to reduce drug-related problems and increase medication adherence. More well-designed, rigorous studies with more sensitive and specific outcomes measures need to be conducted to assess the effect of community pharmacists' contributions to reviewing medications and improving the health of older adults.

BackgroundCollaborative medication review (CMR) practices for older adults are evolving in many countries. Development has been under way in Finland for over a decade, but no inventory of evolved practices has been conducted. The aim of this study was to identify and describe CMR practices in Finland after 10 years of developement.MethodsAn inventory of CMR practices was conducted using a snowballing approach and an open call in the Finnish Medicines Agency’s website in 2015. Data were quantitatively analysed using descriptive statistics and qualitatively by inductive thematic content analysis. Clyne et al’s medication review typology was applied for evaluating comprehensiveness of the practices.ResultsIn total, 43 practices were identified, of which 22 (51%) were designed for older adults in primary care. The majority (n = 30, 70%) of the practices were clinical CMRs, with 18 (42%) of them being in routine use. A checklist with criteria was used in 19 (44%) of the practices to identify patients with polypharmacy (n = 6), falls (n = 5), and renal dysfunction (n = 5) as the most common criteria for CMR. Patients were involved in 32 (74%) of the practices, mostly as a source of information via interview (n = 27, 63%). A medication care plan was discussed with the patient in 17 practices (40%), and it was established systematically as usual care to all or selected patient groups in 11 (26%) of the practices. All or selected patients’ medication lists were reconciled in 15 practices (35%). Nearly half of the practices (n = 19, 44%) lacked explicit methods for following up effects of medication changes. When reported, the effects were followed up as a routine control (n = 9, 21%) or in a follow-up appointment (n = 6, 14%).ConclusionsDifferent MRs in varying settings were available and in routine use, the majority being comprehensive CMRs designed for primary outpatient care and for older adults. Even though practices might benefit from national standardization, flexibility in their customization according to context, medical and patient needs, and available resources is important.

Pharmacists are increasingly involved in medication history taking, medication reconciliation, and review in their daily practice. The objectives of this study were to investigate third-year pharmacy students’ self-assessed competency in medication reviews and gather their feedback for further development of medication review training in their curriculum. The study was conducted as a self-assessment of third-year pharmacy students at the completion of their second three-month internship period in a community pharmacy in 2017–2018. The students were assigned to review medications of a real patient under the supervision of a medication review accredited pharmacist during their internship. The self-assessment was carried out via an e-form, which was created for this study. Recently established national medication review competence recommendations for pharmacists were used as a reference. Students (n = 95, participation rate: 93%) self-assessed their competency as good or very good in 91% (n = 28) of the competency areas listed in the self-assessment. The highest proportion of competencies that were self-assessed as good or very good included using medication risk management databases and evaluating the clinical importance of the information (97%, n = 92). The lowest proportion of competencies was found in applying clinical information from the key laboratory tests to patient care and knowing which laboratory tests are most important to monitor in each condition and medication (36%, n = 34). The students suggested that their pharmacy education should contain more medication review assignments as group work and that an elective course on medication reviews should be compulsory for all pharmacy students.

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