Nurse-led medication reviews and the quality of drug treatment of elderly hospitalized patients

Bergqvist, Monica; Ulfvarson, Johanna; Andersén-Karlsson, Eva

doi:10.1007/s00228-009-0728-2

Cited by 18 publications

(19 citation statements)

References 40 publications

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“…In total, 47 published studies and 32 RCT protocols were included in this systematic review. Details on the sources, reasons for exclusion, and selection process are presented in Figure .…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

Beuscart

Pont

Thevelin

et al. 2017

Brit J Clinical Pharma

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SummaryAim: Medication review has been advocated as one of the measures to tackle the challenge of polypharmacy in older patients, yet there is no consensus on how best to evaluate its efficacy. This study aimed to assess outcome reporting in trials of medication review in older patients. Methods:Randomized controlled trials (RCTs), prospective studies and RCT protocols involving medication review performed in patients aged 65 years or older in any setting of care were identified from: (1) a recent systematic review; (2) RCT registries of ongoing studies; (3) the Cochrane library. The type, definition, and frequency of all outcomes reported were extracted independently by two researchers.Results: 47 RCTs or prospective published studies and 32 RCT protocols were identified. A total of 327 distinct outcomes were identified in the 47 published studies. Merely one fifth (21%) of the studies evaluated the impact of medication reviews on adverse events like adverse drug reactions or drug-related hospital admissions. Most of the outcomes were related to medication use (n=114, 35%) and healthcare use (n=74, 23%). Very few outcomes were patient related outcomes (n=24, 7%). A total of 248 distinct outcomes were identified in the 32 RCT protocols. Overall, the number of outcomes and the number and type of health domains covered by the outcomes varied largely. Conclusion:Outcome reporting from RCTs concerning medication review in older patients is heterogeneous. This review highlights the need for a standardised core outcome set for medication review in older patients, to improve outcome reporting and evidence synthesis. This article is

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“…In total, 47 published studies and 32 RCT protocols were included in this systematic review. Details on the sources, reasons for exclusion, and selection process are presented in Figure .…”

Section: Resultsmentioning

confidence: 99%

A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

Beuscart

Pont

Thevelin

et al. 2017

Brit J Clinical Pharma

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“…After removing 15 papers due to duplicate records and publication dates after 2013, the in- and exclusion criteria were applied to 174 unique publication titles and subsequently to 121 unique abstracts ( Figure 1 ). Of these, 55 full-text publications were reviewed, and 28 were excluded due to: No assessment of clinical significance ( n = 8) [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ], Insufficient data on DRPs ( n = 8) [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], Insufficient data on clinical significance ( n = 5) [ 28 , 29 , 30 , 31 , 32 ], and Wrong study type ( n = 7) [ 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. Finally, 27 unique publications were included in the review [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ,…”

Section: Methodsmentioning

confidence: 99%

Investigating the Relative Significance of Drug-Related Problem Categories

Kjeldsen¹,

Nielsen

Olesen

2017

Pharmacy

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The aim of the review was to investigate whether an assessment of clinical significance can be related to specific drug-related problems (DRPs) and hence may assist in prioritizing individual categories of DRP categorization systems. The literature search using Google Scholar was performed for the period 1990 to 2013 and comprised primary research studies of clinical pharmacy interventions including DRP and clinical significance assessments. Two reviewers assessed the titles, abstracts, and full-text papers individually, and inclusion was determined by consensus. A total of 27 unique publications were included in the review. They had been conducted in 14 different countries and reported a large range of DRPs (71–5948). Five existing DRP categorisation systems were frequently used, and two methods employed to assess clinical significance were frequently reported. The present review could not establish a consistent relation between the DRP categories and the level of clinical significance. However, the categories “ADR” and possibly “Drug interaction” were often associated with an assessed high clinical significance, albeit they were infrequently identified in the studies. Hence, clinical significance assessments do not seem to be useful in prioritizing individual DRPs in the DRP categorization systems. Consequently, it may be necessary to reconsider our current approach for evaluating DRPs.

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“…Several intervention studies have revealed that a multidisciplinary approach for older patients could reduce the number of patients with PIMs [ 27 , 28 ] and detect a high proportion of clinically relevant DRPs [ 29 , 30 ]. One previous study conducted in home care settings revealed that a medication review by a community pharmacist could reduce the number of medications, but it was not clear about the relations of pharmacist intervention to drug costs of PIMs [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

A comparison of estimated drug costs of potentially inappropriate medications between older patients receiving nurse home visit services and patients receiving pharmacist home visit services: a cross-sectional and propensity score analysis

Hamano

Ozone

Tokuda

2015

BMC Health Serv Res

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BackgroundThere have been no multicenter studies that estimated the relations of either nurse or pharmacist home visit program to drug costs of potentially inappropriate medications (PIMs). This study aimed to establish whether patients who used nurse or pharmacist home visit programs (nurse or pharmacist program) had lower drug costs of PIMs than those who did not use nurse or pharmacist programs for older patients living at home.MethodsThis cross-sectional study was conducted in home care settings in Japan, involving 430 patients aged 65 or older, of whom 276 were female. All received regular home visits from five clinics between May and December 2013. After the PIMs were identified with the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, we estimated the drug costs based on actual pharmaceutical prices and measured against who using nurse or pharmacist programs after a propensity score weighted adjustment.ResultsPatients who used nurse programs had lower drug cost of PIMs than those who did not use, but it was not significantly different (5.9 ± 13.1 vs 7.1 ± 13.9 USD per month, P = 0.199). The cost of PIMs for patients who used pharmacist programs also had no difference. (7.2 ± 14.5 vs 5.5 ± 11.5 USD per month, P = 0.06). In the patient groups who used nurse programs, patients who also used pharmacist programs had significantly higher costs of PIMs than those who used only nurse programs (5.5 ± 13.9 vs 2.5 ± 6.0 USD per month, P = 0.006). In patients group who did not use pharmacist programs, patients who only used nurse programs had significantly lower costs of PIMs than those who did not use nurse programs (3.6 ± 7.7 vs 5.8 ± 12.7 USD per month, P = 0.022).ConclusionsPatients who used nurse program have a trend towards lower drug costs of PIMs than those who used nurse and pharmacist program or pharmacist program alone. Although this study tried to adjust the potential confounders as possible as we could by using propensity score analysis, further studies are needed to confirm our results.

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Nurse-led medication reviews and the quality of drug treatment of elderly hospitalized patients

Abstract: International audienc

Cited by 18 publications

References 40 publications

A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

A systematic review of the outcomes reported in trials of medication review in older patients: the need for a core outcome set

Investigating the Relative Significance of Drug-Related Problem Categories

A comparison of estimated drug costs of potentially inappropriate medications between older patients receiving nurse home visit services and patients receiving pharmacist home visit services: a cross-sectional and propensity score analysis

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