Results from a project to develop systematic patient focused clinical pharmacy services. The Lund Integrated Medicines Management model

Eriksson, Tommy

doi:10.1136/ejhpharm-2013-000332

Cited by 13 publications

(18 citation statements)

References 16 publications

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“…Both the Integrated Medicines Management (IMM)12 and the Lund Integrated Medicines Management (LIMM)19 models of care proved that this collaborative approach identified, resolved and prevented drug-related problems. These models have acted as a service template from which PACT has evolved.…”

Section: Discussionmentioning

confidence: 99%

“…However, clinical pharmacy is not universal in every Irish hospital, the prevailing reason being that resources are not sufficient to permit pharmacists to have patient facing roles 45. The collective evidence9 10 12–15 18 19 25 creates a compelling argument for the integration of clinical pharmacists into the multidisciplinary healthcare team in a manner that facilitates optimal collaboration and team working. This study adds to the body of evidence demonstrating the benefits of collaborative pharmaceutical care on medication and patient safety of acutely hospitalised older patients.…”

Section: Discussionmentioning

confidence: 99%

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Impact of the Collaborative Pharmaceutical Care at Tallaght Hospital (PACT) model on medication appropriateness of older patients

et al. 2015

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ObjectivesA high prevalence of potentially inappropriate prescribing (PIP) has been identified in older patients in Ireland. The impact of the Collaborative Pharmaceutical Care at Tallaght Hospital (PACT) model on the medication appropriateness of acute hospitalised older patients during admission and at discharge is reported. MethodsUncontrolled before-after study. The study population for this study was medical patients aged 65 years, using 3 regular medicines at admission, taken from a previous before-after study. Standard care involved clinical pharmacists being ward-based, contributing to medication history taking and prescription review, but not involved at discharge. The innovative PACT model involved clinical pharmacists being physician team-based, leading admission and discharge medication reconciliation and undertaking prescription review, with authority to change the prescription during admission or at discharge. The primary outcome was the Medication Appropriateness Index (MAI) score applied pre-admission, during admission and at discharge. ResultsSome 108 patients were included (48 PACT, 60 standard). PACT significantly improved the MAI score from pre-admission to admission (mean difference 2.4, 95% confidence interval (95CI) 1.0-3.9, p<0.005), and from pre-admission to discharge (mean difference 4.0, 95CI 1.7-6.4, p<0.005). PACT resulted in significantly fewer drugs with one or more inappropriate rating at discharge (PACT 15.0%, standard 30.5%, p<0.001). The MAI criteria responsible for most inappropriate ratings was "correct directions" (4.8% PACT, 17.3% standard), expense (5.3%, 5.7%) and dosage (4.0%, 0.6%). PACT suggestions to optimize medication use were accepted more frequently, and earlier in the hospital episode, than standard care (96.7%, 69.3%, p<0.05). ConclusionCollaborative pharmaceutical care between physicians and pharmacists from admission to discharge, with authority for pharmacists to amend the prescription, improves medication appropriateness in older hospitalised Irish patients. Key messagesWhat is already known on this subject - Older patients are at greater risk of drug related problems, including adverse drug effects, than younger patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of the Collaborative Pharmaceutical Care at Tallaght Hospital (PACT) model on medication appropriateness of older patients

et al. 2015

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“…I have been responsible for the development and research on the Lund Integrated Medicines Management model. 24 It includes a systematic approach for medication reconciliation at admission to hospital, including a list of actual prescribed and used medications. The Morisky compliance assessment scale 25 and BMQ – specific 20 are used to further assess compliance and behavior if needed.…”

Section: Beliefs Behavior and Concordance Methodsmentioning

confidence: 99%

Evidence-based and pragmatic steps for pharmacists to improve patient adherence

Eriksson¹

2015

IPRP

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All strategies and tools to improve the potential outcomes of medications therapy are a waste of time if the clients do not take their medication as prescribed. The aim of this paper is to help pharmacists to help their clients to improve outcomes of medicines based on improving their compliance to evidence-based pharmacotherapy. To reach a good compliance (result), you have to have agreement and concordance (method) between the practitioner and the client. Barriers and strategies for this, including identifying compliance problems and reasons for it, methods for improving information and communication, the client’s participation, and responsibility for their own health, are presented mainly based on Cochrane reviews. Also some general pragmatic suggestions for how pharmacists can assist their clients the best are given.

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“…There are several systematic team-based clinical pharmacy practice models including activities like medication reconciliation and medication review,19 20 but there are only few examples where the models have been used as training modules for the students to identify, solve and prevent drug-related problems. One example is the pharmacy programme at Lund University Sweden but this programme has still not started 20…”

Section: Teaching and Training Students On Evidence-based Pharmacy Prmentioning

confidence: 99%

Chapter 12: Evidence-based skills and practices for the future of pharmacy

Eriksson

Wiffen

Hao³

2015

Eur J Hosp Pharm

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Results from a project to develop systematic patient focused clinical pharmacy services. The Lund Integrated Medicines Management model

Cited by 13 publications

References 16 publications

Impact of the Collaborative Pharmaceutical Care at Tallaght Hospital (PACT) model on medication appropriateness of older patients

Impact of the Collaborative Pharmaceutical Care at Tallaght Hospital (PACT) model on medication appropriateness of older patients

Evidence-based and pragmatic steps for pharmacists to improve patient adherence

Chapter 12: Evidence-based skills and practices for the future of pharmacy

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