Evaluation of a collaborative care approach between general practitioners and clinical pharmacists in primary care community settings in elderly patients on polypharmacy in Slovenia: a cohort retrospective study reveals positive evidence for implementation

Autor: Matej Stuhec, Katja Gorenc, Erika Zelko
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: BMC Health Services Research, Vol 19, Iss 1, Pp 1-9 (2019)
Druh dokumentu: article
ISSN: 1472-6963
DOI: 10.1186/s12913-019-3942-3
Popis: Abstract Background The population of developed countries is aging, leading to an increase in the use of medication in daily practice, which can lead to serious treatment costs and irrational polypharmacy. A collaborative care approach, such as providing medication review service provided by a clinical pharmacist (CP), is a possible way to reduce drug-related problems and irrational polypharmacy. The aim of this study was to determinate whether a CP’s medication review service can improve the quality of drug prescribing in elderly patients treated with polypharmacy in primary care. Methods In a retrospective observational medical chart review study, patients aged 65 years or more in the period 2012–2014 who received 10 or more medications concomitantly and who were screened by a CP were included. Data on pharmacotherapy and CPs’ interventions were obtained from the patients’ medical records (non-electronic chart review). Potential drug-drug interactions (pDDIs) were determined with Lexicomp Online™ 3.0.2. Only potential X-type DDIs (pXDDIs) were included. Potentially inappropriate medications in the elderly (PIMs) were identified using the PRICUS list. Results Ninety-one patients were included. The CPs suggested 625 interventions, of which 304 (48.6%) were accepted by the general practitioners (GPs). After adopting the CPs’ interventions, the number of total medications decreased by 11.2% (p
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