Development of a screening tool to identify patients likely to benefit from clinical pharmacist review in a home-based primary care population

Stewart, Amy; Lovato, James; Zimmer, Rachel; Stewart, Alyssa P.; Hinely, Molly; Yang, Mia

doi:10.1016/j.japh.2020.03.008

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…The acceptance rates for primary care providers were 69% [ 23 ], in contrast with 30% in our study. A recent study in the private sector had pharmacy resident-provider pairs making home visits to 25 homebound patients [ 24 ]. However, their study focused on developing a screening tool that identifies identify HBPC patients likely to benefit from in-home pharmacist review.…”

Section: Discussionmentioning

confidence: 99%

Pharmacist medication review: An integrated team approach to serve home-based primary care patients

et al. 2021

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Background Comprehensive medication review is a patient-centered approach to optimize medication use and improve patient outcomes. This study outlines a pilot model of care in which a remote corporate-based clinical pharmacist implemented comprehensive medication reviews for a cohort of medically complex home-based primary care (HBPC) patients. Method Ninety-six medically complex patients were assessed for medication-related problems. Data collected on these patients were: number of chronic conditions, number of medications, appropriate indication for each medication, dose appropriateness, drug interactions, recommendations for medication optimization and deprescribing. The number of accepted recommendations by the HBPC practice was analyzed. Results On average, the patients were 82 years old and had 13 chronic conditions. They were taking a median of 17 medications. Over a four-month pilot period, 175 medication recommendations were made, and 53 (30.3%) of them were accepted, with most common being medication discontinuation, deprescribing, and dose adjustments. Sixty-four (66.7%) patients were on a medication listed as potentially inappropriate for use in older adults. The most common potentially inappropriate medication was a proton-pump inhibitor (38.5%), followed by aspirin (24%), tramadol (15.6%), a benzodiazepine (13.5%) or an opioid (8.3%). Eighty-one medications were recommended for deprescribing and 27 medications were discontinued (33.3%). There were 24 recommended dose adjustments and 11 medications were dose adjusted (45.8%). Thirty-four medications were suggested as an addition to the current patient regimen, 2 medications were added (5.9%). Conclusion Pharmacist comprehensive medication review is a necessary component of the HBPC healthcare continuum. Additional research is needed to examine whether aligning pharmacists to deliver support to HBPC improves clinical outcomes, reduces healthcare expenditures and improves the patient’s experience.

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Section: Discussionmentioning

confidence: 99%

Pharmacist medication review: An integrated team approach to serve home-based primary care patients

et al. 2021

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“…Similarly, frailty (by the adapted eFI) was associated with greater post-acute care needs, higher 30-day readmission rates, and higher all-cause mortality within 6 months for non-urgent surgery ( 70 ). Furthermore, adapted eFI scores >0.32 may identify patients most likely to benefit from in-home pharmacist medication reviews, as shown in a small sample study ( 71 ). At last, the eFI has also been attempted to predict in-patient mortality after hospitalization or ICU admission for critically ill community-dwelling patients, but maybe less predictive value than the hospital frailty risk score (HRFS, constructed from hospital data, mainly ICD codes) ( 72 , 73 ).…”

Section: Application Of These Toolsmentioning

confidence: 93%

Identifying Frail Patients by Using Electronic Health Records in Primary Care: Current Status and Future Directions

Luo

Liao

Zou

et al. 2022

Front. Public Health

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With the rapidly aging population, frailty, characterized by an increased risk of adverse outcomes, has become a major public health problem globally. Several frailty guidelines or consensuses recommend screening for frailty, especially in primary care settings. However, most of the frailty assessment tools are based on questionnaires or physical examinations, adding to the clinical workload, which is the major obstacle to converting frailty research into clinical practice. Medical data naturally generated by routine clinical work containing frailty indicators are stored in electronic health records (EHRs) (also called electronic health record (EHR) data), which provide resources and possibilities for frailty assessment. We reviewed several frailty assessment tools based on primary care EHRs and summarized the features and novel usage of these tools, as well as challenges and trends. Further research is needed to develop and validate frailty assessment tools based on EHRs in primary care in other parts of the world.

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The role of the clinical pharmacist in mental health hospital-in-the-home: A scoping review

Farag

Chalmers

Hoti

et al. 2022

Research in Social and Administrative Pharmacy

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Development of a screening tool to identify patients likely to benefit from clinical pharmacist review in a home-based primary care population

Cited by 4 publications

References 13 publications

Pharmacist medication review: An integrated team approach to serve home-based primary care patients

Pharmacist medication review: An integrated team approach to serve home-based primary care patients

Identifying Frail Patients by Using Electronic Health Records in Primary Care: Current Status and Future Directions

The role of the clinical pharmacist in mental health hospital-in-the-home: A scoping review

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