| Autor: |
Ponjee, G. H. M., van de Meerendonk, H. W. P. C., Janssen, M. J. A., Karapinar-Çarkıt, F. |
| Předmět: |
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| Zdroj: |
Nederlands Platform voor Farmaceutisch Onderzoek; 8/20/2019, Vol. 4, p1-6, 6p |
| Abstrakt: |
OBJECTIVE To assess the effect of a Geriatric Stewardship on drugrelated problems (DRPs) reported by patients after discharge. DESIGN An implementation study (pre-post design). METHODS Hospitalized patients aged ≥ 65 years with polypharmacy and a risk factor for frailty were included from February 2017 until August 2018. The pre-group received usual care (control: no medication review). The post-group received the Geriatric Stewardship intervention. This consisted of an extended medication review based on a (1) review of the medication list and clinical records to draft initial recommendations, (2) consultation with the general practitioner and community pharmacist to discuss the hospital based recommendations, (3) patient interview to assess patient needs, and (4) multidisciplinary evaluation of all the previous steps by a hospital pharmacist and a geriatrician to draft final recommendations. Two weeks post-discharge, patient-reported DRPs were assessed by telephone using a validated questionnaire. DRPs were classified into: drug-related complaints, practical problems, and questions about medication. The primary outcome was the number and type of DRPs per patient. Secondary, in the intervention group the number of initial recommendations that were altered after consultations with PCPs and patient interviews was assessed. A poisson regression was used to compare the groups on the primary outcome. RESULTS In total, 127 patients were analyzed (control: 74, intervention: 53). Intervention patients reported fewer DRPs compared to control, 2.8 versus 3.3 per patient (RRadjusted = 0.83, 95% CI = 0.66-1.05). The difference was due to a halving in drugrelated complaints (P < 0.05). Nearly 30% of the initial recommendations based on the patient's medication list and clinical records were discarded or modified after consultations with primary care providers and patient interviews. CONCLUSION The implementation of a Geriatric Stewardship tends to reduce DRPs after discharge, which provides a good indication for further research. One in three initial medication review recommendations were altered due to PCPs and patient input. This shows that medication reviews should not be based on clinical records only. Patient participation and consultations with primary care providers contributes to a medication review that is tailored to the patient's individual preferences and medical history. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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