A Collaborative Medication Review Including Deprescribing for Older Patients in an Emergency Department: A Longitudinal Feasibility Study

Autor: Morten Baltzer Houlind, Aino Leegaard Andersen, Charlotte Treldal, Lillian Mørch Jørgensen, Pia Nimann Kannegaard, Luana Sandoval Castillo, Line Due Christensen, Juliette Tavenier, Line Jee Hartmann Rasmussen, Mikkel. Zöllner Ankarfeldt, Ove Andersen, Janne Petersen
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of Clinical Medicine, Vol 9, Iss 2, p 348 (2020)
Druh dokumentu: article
ISSN: 2077-0383
DOI: 10.3390/jcm9020348
Popis: Medication review for older patients with polypharmacy in the emergency department (ED) is crucial to prevent inappropriate prescribing. Our objective was to assess the feasibility of a collaborative medication review in older medical patients (≥65 years) using polypharmacy (≥5 long-term medications). A pharmacist performed the medication review using the tools: Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) criteria, a drug−drug interaction database (SFINX), and Renbase® (renal dosing database). A geriatrician received the medication review and decided which recommendations should be implemented. The outcomes were: differences in Medication Appropriateness Index (MAI) and Assessment of Underutilization Index (AOU) scores between admission and 30 days after discharge and the percentage of patients for which the intervention was completed before discharge. Sixty patients were included from the ED, the intervention was completed before discharge for 50 patients (83%), and 39 (61.5% male; median age 80 years) completed the follow-up 30 days after discharge. The median MAI score decreased from 14 (IQR 8-20) at admission to 8 (IQR 2-13) 30 days after discharge (p < 0.001). The number of patients with an AOU score ≥1 was reduced from 36% to 10% (p < 0.001). Thirty days after discharge, 83% of the changes were sustained and for 28 patients (72%), 1≥ medication had been deprescribed. In conclusion, a collaborative medication review and deprescribing intervention is feasible to perform in the ED.
Databáze: Directory of Open Access Journals
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