Literature DB >> 31156894

Impact of medication review, within a shared decision-making framework, on deprescribing in people living in care homes.

Wasim Baqir1,2, Julian Hughes1, Tania Jones3, Steven Barrett1, Nisha Desai1, Richard Copeland1, David Campbell1, Annie Laverty1.   

Abstract

OBJECTIVES: The key objectives of this study were to quantify extent of prescribing, reasons for deprescribing, common therapeutic groups of medicines deprescribed and adverse events.
METHODS: A retrospective analysis was carried out on a quality improvement project where 422 care home residents in 20 care homes received a medicines optimisation review with a pharmacist and other members of the healthcare team (general medical practitioner, care home nurse). Data on number, type and cost of medicines were collected. Statistical analysis was performed to test for differences between pharmacist-only review and the pharmacist plus general practitioner (GP), and to identify any correlation between the original number of medicines and the number of medicines stopped.
RESULTS: Of the 422 patients reviewed, 298 (70.6%) had at least one medicine stopped with 704 medicines being stopped. This represented 19.5% of the medicines originally prescribed (3602 medicines). There was no statistically significant difference between pharmacist only and pharmacist plus GP in terms of stopping medicines. The main groups of medicines stopped were laxatives, skin products and bone protection. There was weak correlation between the original number of medicines prescribed and the number stopped.
CONCLUSIONS: This study has shown that medicines optimisation reviews can lead to a reduction in polypharmacy for care home residents through a deprescribing process. Patients' medicine regimens were simplified and optimised while making financial significant savings for the National Health Service.

Entities:  

Keywords:  GERIATRIC MEDICINE; PRIMARY CARE; deprescribing; nursing home; pharmacist

Year:  2017        PMID: 31156894      PMCID: PMC6451483          DOI: 10.1136/ejhpharm-2016-000900

Source DB:  PubMed          Journal:  Eur J Hosp Pharm        ISSN: 2047-9956


  22 in total

1.  Effects of a pharmacist's medication review in nursing homes. Randomised controlled trial.

Authors:  L Furniss; A Burns; S K Craig; S Scobie; J Cooke; B Faragher
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2.  Multidisciplinary medication review in nursing home residents: what are the most significant drug-related problems? The Bergen District Nursing Home (BEDNURS) study.

Authors:  S Ruths; J Straand; H A Nygaard
Journal:  Qual Saf Health Care       Date:  2003-06

Review 3.  Deprescribing trials: methods to reduce polypharmacy and the impact on prescribing and clinical outcomes.

Authors:  Danijela Gnjidic; David G Le Couteur; Lisa Kouladjian; Sarah N Hilmer
Journal:  Clin Geriatr Med       Date:  2012-02-21       Impact factor: 3.076

Review 4.  American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults.

Authors: 
Journal:  J Am Geriatr Soc       Date:  2012-02-29       Impact factor: 5.562

5.  Quality use of medicines in residential aged care.

Authors:  Michael Somers; Ella Rose; Dasha Simmonds; Claire Whitelaw; Janine Calver; Christopher Beer
Journal:  Aust Fam Physician       Date:  2010-06

6.  Clinical medication review by a pharmacist of elderly people living in care homes--randomised controlled trial.

Authors:  Arnold Geoffrey Zermansky; David Phillip Alldred; Duncan Robert Petty; David K Raynor; Nick Freemantle; Joanne Eastaugh; Peter Bowie
Journal:  Age Ageing       Date:  2006-08-12       Impact factor: 10.668

7.  A study of medication reviews to identify drug-related problems of polypharmacy patients in the Dutch nursing home setting.

Authors:  F Finkers; J G Maring; F Boersma; K Taxis
Journal:  J Clin Pharm Ther       Date:  2007-10       Impact factor: 2.512

8.  An outreach geriatric medication advisory service in residential aged care: a randomised controlled trial of case conferencing.

Authors:  Maria Crotty; Julie Halbert; Debra Rowett; Lynne Giles; Robert Birks; Helena Williams; Craig Whitehead
Journal:  Age Ageing       Date:  2004-09-22       Impact factor: 10.668

9.  STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteria.

Authors:  Paul Gallagher; Denis O'Mahony
Journal:  Age Ageing       Date:  2008-10-01       Impact factor: 10.668

10.  Estimating length of stay in publicly-funded residential and nursing care homes: a retrospective analysis using linked administrative data sets.

Authors:  Adam Steventon; Adam Roberts
Journal:  BMC Health Serv Res       Date:  2012-10-31       Impact factor: 2.655

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  4 in total

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Journal:  Front Pharmacol       Date:  2020-08-28       Impact factor: 5.810

2.  Educational supervision to support pharmacy professionals' learning and practice of advanced roles.

Authors:  Michelle Styles; Helen Middleton; Ellen Schafheutle; Matthew Shaw
Journal:  Int J Clin Pharm       Date:  2022-05-16

3.  The Care Home Independent Prescribing Pharmacist Study (CHIPPS)-a non-randomised feasibility study of independent pharmacist prescribing in care homes.

Authors:  Jacqueline Inch; Frances Notman; Christine M Bond; David P Alldred; Antony Arthur; Annie Blyth; Amrit Daffu-O'Reilly; Joanna Ford; Carmel M Hughes; Vivienne Maskrey; Anna Millar; Phyo K Myint; Fiona M Poland; Lee Shepstone; Arnold Zermansky; Richard Holland; David Wright
Journal:  Pilot Feasibility Stud       Date:  2019-07-11

Review 4.  How Do Pharmacists Practice in Aged Care? A Narrative Review of Models from Australia, England, and the United States of America.

Authors:  Ibrahim Haider; Mark Naunton; Rachel Davey; Gregory M Peterson; Wasim Baqir; Sam Kosari
Journal:  Int J Environ Res Public Health       Date:  2021-12-03       Impact factor: 3.390

  4 in total

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