In-hospital medication reviews reduce unidentified drug-related problems

Bondesson, Åsa Åb; Eriksson, Tommy; Kragh, Annika; Holmdahl, Lydia; Midlöv, Patrik; Höglund, Peter

doi:10.1007/s00228-012-1368-5

Cited by 42 publications

(43 citation statements)

References 36 publications

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“…This results shows that the introduction of the LIMM-model was successful. These results are in accordance with another study performed by members of our research group (20). We believe that the high valuations can be explained by several factors.…”

supporting

confidence: 93%

“…In a study performed by our group at a similar department but at a University Hospital 9.9 DRPs were identified per patient, 65% of the DRPs was discussed with the physicians who adjusted 93.1% and rejected 6.9% of the suggestions (20). Gillespie et al identified 2.6 DRPs per patient, all of which were put forward and the physicians made adjustments for 69% of the DRPs while 23% of the suggestions were rejected (16).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the individual LIMM-tools have been shown to reduce unidentified DRPs during the patients" hospital stay (20) and reduce the need for health care contacts caused by medication errors (21). These findings describe outcomes for the patient, but we were also interested in how the model is appreciated by the health care personnel and how it affects the daily work regarding DRPs.…”

Section: The Process Of Identifying Solving and Preventing Drug Relamentioning

confidence: 99%

“…A questionnaire, using six-point ordinal scales from 1 (no benefit) to 6 (great benefit), was used. This questionnaire has previously been developed and used by our research group (20) and is shown in Appendix I.…”

Section: The Health Care Personnel's Attitudes Towards the Limm-modelmentioning

confidence: 99%

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The process of identifying, solving and preventing drug related problems in the LIMM-study

et al. 2011

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Objective To avoid negative effects of drug treatment and need for additional medical care, drug treatment must be individualised. Our research group has developed a model for clinical pharmacy which improves several aspects of the patient's drug treatment. This study describes the process behind these improvements, i.e. drug related problems identified by pharmacists within a clinical pharmacy service.Setting Three wards at a department of internal medicine.Method Pharmacists performed systematic interventions during the patient's hospital stay, aiming to identify, solve and prevent drug related problems in the elderly. Identified drug related problems were put forward to the health care team and discussed. Information on identified problems, and their outcomes was collected and analysed. A questionnaire was used to evaluate the health care personnel's attitudes towards the process. Main outcome measureThe number of drug related problems identified by the clinical pharmacists, the proportion of problems discussed with the physicians, the proportion of problems adjusted by the physicians and whether pharmacists and physicians prioritised any subgroup of drug related problems when choosing which problems to address. Finally, we wanted to evaluate the health care personnel's attitudes towards the model. ResultsIn total, 1227 problem were identified in 190 patients. The pharmacists discussed 685 (55.8%) of the identified problems with the physicians who accepted 438 (63.9%) of the suggestions. There was no significant difference in which subgroup to put forward and which to adjust. There was a high response rate (84%) to the questionnaire, and the health care personnel estimated the benefits to be very high, both for the patients and for themselves. ConclusionThe process for identifying, solving and preventing drug related problems was good and the different types of problems were considered equally important. The addition of a clinical pharmacy service was considered very useful. This suggests that the addition of our clinical pharmacy service to the hospital setting add skills of great importance. KeywordsClinical pharmacy service, Drug related problem (DRP), elderly, inpatients, LIMM-study,

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supporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: The Process Of Identifying Solving and Preventing Drug Relamentioning

confidence: 99%

Section: The Health Care Personnel's Attitudes Towards the Limm-modelmentioning

confidence: 99%

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The process of identifying, solving and preventing drug related problems in the LIMM-study

et al. 2011

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“…That said, hospitalization may indeed provide an opportunity to discontinue these medications in a monitored setting, and is increasingly being viewed by primary care providers (PCPs) and hospitalists as an opportunity for medication reconciliation and paring down of medications lists. 9,10 If this approach is taken, communication with relevant outpatient providers, including PCPs and gastroenterologists where applicable, is of paramount importance.…”

mentioning

confidence: 99%

Reconsidering a Common Practice: In-Hospital Use of PPIs

Herzig

Nardino

2015

J GEN INTERN MED

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Medication review in hospitalised patients to reduce morbidity and mortality

Christensen

Lundh

2016

Cochrane Database of Systematic Reviews

198

167

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of findings for the main comparison. Medication review compared with standard care for hospitalised adult patients Medication review compared with standard care for hospitalised adult patients Patient or population: hospitalised adult patients Intervention: medication review Comparison: standard care Illustrative comparative risks* (95% CI) Assumed risk Corresponding risk Outcomes Standard care Medication review Relative effect (95% CI) Number of participants (studies) Certainty of the evidence (GRADE) Comments Low-risk population 200 per 1000 a 204 per 1000 (174 to 238) High-risk population Mortality (all-cause) 1 year 400 per 1000 a 408 per 1000 (348 to 476) RR 1.02 (0.87 to 1.19) 3218 (9 trials) ⊕⊕⊝⊝ Low b,c NA Low-risk population 300 per 1000 a 285 per 1000 (261 to 312) High-risk population Hospital readmission (all-cause)

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In-hospital medication reviews reduce unidentified drug-related problems

Cited by 42 publications

References 36 publications

The process of identifying, solving and preventing drug related problems in the LIMM-study

The process of identifying, solving and preventing drug related problems in the LIMM-study

Reconsidering a Common Practice: In-Hospital Use of PPIs

Medication review in hospitalised patients to reduce morbidity and mortality

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