Outcomes of Pharmacists' Involvement with Residents of Special Nursing Homes for the Elderly

Abstract

The current study aimed to examine the outcomes of pharmacists' involvement with elderly people in special nursing homes. We analyzed 58 cases involving regular visits by community pharmacists to 41 residents. The residents' mean age was 87.8±6.9 years, and 68.3% were prescribed 6 or more types of medication. Antipsychotic and insomnia medication was taken by 24.4% and 31.8% of residents, respectively. Pharmaceutical consultation following medication use accounted for 60.3% of pharmacists' involvement with residents. The outcomes of these consultations included improvements in prescription content; the identification and prevention of adverse drug events; improvement in activities of daily living; and improvement in test results, sleep, and urination/bowel control. The results also suggested that pharmacists' intervention reduced drug costs. Information that facilitated involvement was most frequently acquired via conversations (67.2%) and conferences (24.1%) in the facilities. The most common information sources were care workers (72.4%), followed by nurses (37.9%), physicians (6.9%), and functional training instructors (6.9%). Information was also acquired from patients (3.4%) and their family members (5.2%). The findings indicated that regular visits by pharmacists to facilities for elderly people and conversations between residents, their family members, and physicians, nurses and various other professionals improved various pharmacotherapy outcomes.

Study of pharmacist intervention in polypharmacy among older patients: Non‐randomized, controlled trial

“…In step 2, the pharmacist checked residents’ eating, excretory functions, sleep and motor status. The pharmacist then identified issues and decided on what measures to take while inputting the information into an “activity‐recording program” that had been developed in PC format based on the results of the retrospective study . The program was designed to set and record the actions that had been taken by the pharmacist, as well as the items, types and content of the end‐points for assessing outcomes.…”

“…The pharmacist then identified issues and decided on what measures to take while inputting the information into an "activityrecording program" that had been developed in PC format based on the results of the retrospective study. 19 The program was designed to set and record the actions that had been taken by the pharmacist, as well as the items, types and content of the end-points for assessing outcomes. The primary information that was recorded consisted of the following: interdisciplinary information obtained from physicians, nurses and other healthcare workers; the way in which the information was obtained and who provided the information; medication and PIM status; potentially unnecessary medications or potential adverse events; issues identified by the pharmacist and actions taken; recommendations or interdisciplinary proposals for the physician; nurse and care worker education and training; adverse events; post-medication pharmaceutical management; and prognosis ( Fig.…”

“…The only Japanese reports on pharmacist intervention‐based outcomes in nursing homes are a report of the effect of reduced medication based on prescriptions proposed by pharmacists to physicians and our own retrospective study, in nursing homes for older adults . The present study was intended to develop a specific method of interdisciplinary interventions by pharmacists in the drug therapy of older polypharmacy patients at nursing homes, and to prospectively show the outcomes achieved by such interventions.…”

Conceptually-Theoretical Justification and Updating of the Preventive Approach in the Implementation of a Pharmacist’s Information Consultancy Services in the Public Health System

“…В научных материалах коллег из итальянского университета Катандзаро доказана необходимость специальных знаний о ЛС при выборе торгового наименования ЛП, проиллюстрированы отдельные фармацевтические аспекты дженериков (воспроизведенных ЛП) в отношении оригинальных ЛП на примере конкретных клинических случаев и приведены аргументы релятивности их использования в терапевтической практике [10]. Коллеги из Турции [11] и Японии [12] доказывают необходимость фармацевтического знания в профилактике проблем фармакотерапии в гериатрии. Американские коллеги обосновывают значимость фармацевтической информации в охране детского здоровья и выборе безопасной фармакотерапии в детской практике [13,14].…”

“…Методология ПФК основана на теории индивидуального подхода к пациенту при выборе фармакотерапии: «Разные больные по-разному реагируют на один и тот же лекарственный препарат, поэтому каждое на- значение нужно рассматривать как эксперимент, в ходе которого должна быть проверена гипотеза об индивидуальной эффективности и безопасности лекарственного средства». 12 Ученые фармакологи отмечают, что особое значение в организации медицинской помощи имеет индивидуальный подход к фармакотерапии, который базируется на особенностях соотношений клинических эффектов ЛС с фармакодинамическими и фармакологическими процессами [27] и приверженности пациента врачебным назначениям («Лекарства не будут работать, если их не принимать» 13 ). Вместе с тем, организаторы фармацевтического дела, рассматривают фармацевтическое консультирование как составную часть фармацевтической и медицинской помощи, целью которой выступает сохранение здоровья пациента посредством удовлетворения потребностей в рациональной фармакотерапии и соблюдения правил использования ЛП.…”