Pharmaceutical care for older people: recording and review of medication following admission to hospital

Abstract

Focal points The National Service Framework for Older People calls for regular medication review for all patients over the age of 75 Studies have shown that pharmacists take more accurate admission medication histories than do junior medical staff, but few studies have evaluated pharmacist‐mediated medication review An ethnographic study was used to develop structured protocols for medication review and history taking, which were evaluated by a pharmacist on two acute medical wards The study found that a structured medication review by a pharmacist results in more appropriate prescribing, including discontinuing drugs no longer required or contraindicated, avoiding adverse drug reactions and tailoring therapy to patient's needs

Medication issues for nursing older people (part 1)

“…Hospital pharmacists have a major role advising on the selection and indications for rational drug use. It has been found that pharmacists carrying out reviews of medication resulted in more appropriate prescribing and fewer adverse drug reactions (Tulip et al 2002). However, the Nursing and Midwifery Council (NMC) (2004) has identified that part of the nurse's role is to be aware of potential side effects of medication.…”

Medication review for the older person

“…43 Evidence suggests that hospital pharmacists have been effective in improving the accuracy of documentation related to drug history, and decreasing prescribing costs and risk to patients. Hospital pharmacists have been encouraged to participate in post-admission ward rounds to detect inappropriate prescribing and reduce prescribing costs and medication errors.…”