Impact of practice based clinical pharmacist led medication reviews on ambulatory patients with hyper polypharmacy
| Autor: | Lawrence Brad, Steve R. Williams |
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| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | British Journal of General Practice. 68:bjgp18X697097 |
| ISSN: | 1478-5242 0960-1643 |
| DOI: | 10.3399/bjgp18x697097 |
| Popis: | BackgroundProblematic polypharmacy is at the heart of medicines usage in patients with multimorbidity, and review by medicines experts in primary care is essential.AimTo assess the impact of medication reviews by a clinical pharmacist on ambulatory patients with hyper polypharmacyMethodThe study took place within a large urban practice in Dorset. Patients over ≥75 years old with ≥10 regular medicines were identified using the NHS Business Service Authority Polypharmacy database. Patients who were housebound, lived in a care home or with dementia were excluded and GP partners were asked to confirm the validity of these exclusions. Patients were sent a letter from their personalised GP inviting them to attend a 30-minute consultation with a clinical pharmacist prescriber employed by the practice. The age and frailty status of patients, number of medicines pre- and post-consultation, and the nature of medicines optimisation decisions were recorded. Patient satisfaction with the consultations was assessed using a 7-point Likert scale questionnaire.Results91 out of 17000 (0.5%) patients were receiving ≥ 10 medicines. 25 patients were excluded and to date 20/26 (77 %) patients invited had a consultation booked or been seen. Medicines optimisation changes varied in number and complexity and controversial changes discussed with patients’ individual GP. To date all patients rated the consultation as very good to outstanding (median score 6.5)ConclusionAmbulatory patients with hyper polypharmacy highly rated medication reviews with a clinical pharmacist and medication regimens in most were optimised through shared decision making. |
| Databáze: | OpenAIRE |
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