No abstract

Data from this study indicate that long-term care clinicians might not be adequately differentiating patient profiles and safety criteria when initiating residents on osteoporosis pharmacotherapy, as evidenced by similar prescribing trends in both the alendronate and calcitonin groups. Given its package insert's statements regarding use of alendronate in the renally compromised, results from the alendronate group were particularly problematic as a result of the large number of residents with either insufficient renal function or undocumented serum creatinine. These data demonstrate that osteoporosis could be a disease state that should be more closely analyzed through drug utilization reviews and represent yet another opportunity for improved collaboration between medical directors and consultant pharmacists.

Among long-term care residents with dementia who received low doses of risperidone or olanzapine, the incidence of adverse events was low. When considering adverse events of particular concern in the elderly, specifically falls and laxative use, risperidone may be preferred over olanzapine in this population.

Drug therapy is one of a variety of tools used by clinicians to manage symptoms and diseases in patients. To understand the medication regimen review process, it is important to understand the big picture of patient care and how medications fit into this overall scheme. The framework for patient management is known as "the care process."

The medication regimen review is considered the core activity of the consultant pharmacist. This article, the first in a series of three, will provide an introduction and overview of the medication regimen review. Goals of the MRR will be presented, along with a discussion of the different types of MRR. The importance of focusing on the values, priorities, and goals of each individual patient is emphasized. Other articles in this series will provide more specifics about the medication regimen review process.