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Impact of medication reviews on inappropriate prescribing in aged care

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Koria, LG, Zaidi, STR ORCID: 0000-0002-2031-1055, Peterson, GM ORCID: 0000-0002-6764-3882, Nishtala, P, Hannah, PJ and Castelino, R 2018 , 'Impact of medication reviews on inappropriate prescribing in aged care' , Current Medical Research and Opinion, vol. 34, no. 5 , pp. 833-838 , doi: 10.1080/03007995.2018.1424624.

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Abstract

Background:Inappropriate prescribing (IP) is prevalent among elderly people in aged care facilities. Little has been published on the effect of pharmacists performing residential medication management reviews (RMMRs) in aged care on the appropriateness of prescribing. RMMRs represents a key strategy for achieving quality use of medicines, by assisting residents in aged care facilities and their carers to better manage their medicines. However, the structure of RMMR has moved from annual to every two years for each resident.Objectives:The primary objective of this study was to investigate the impact of pharmacists performing RMMRs on medication use appropriateness, as measured by the Medication Appropriateness Index (MAI).Methods:Retrospective analysis of RMMRs pertaining to 223 aged care residents aged ≥65 years in Sydney, Australia. The MAI was applied on two RMMR cohorts; newer cohort (n = 111, 2015) i.e. following the recent changes to the RMMR funding and older cohort (n = 112, 2012) at baseline, after pharmacists' recommendations (assuming all pharmacists' recommendations were accepted by the General Practitioner [GP]), and after the actual uptake of pharmacists' recommendations by the GP. Differences in inappropriate prescribing were measured using the Wilcoxon sign rank test.Results:Overall, all patients in the study (n = 223) had at least one inappropriate rating at baseline (median MAI score of 26 for the old cohort and 27 for the newer cohort). The median cumulative MAI scores were significantly lower after the RMMRs by pharmacists (15.5 and 20 for the old and new cohort respectively, p Conclusion:This study shows that pharmacist-led medication reviews are effective in reducing inappropriate prescribing among aged care residents, as demonstrated by the reduction in MAI scores. Future studies should focus on the impact of such a decrease on patient outcomes.

Item Type: Article
Authors/Creators:Koria, LG and Zaidi, STR and Peterson, GM and Nishtala, P and Hannah, PJ and Castelino, R
Keywords: Medication appropriateness prescribing elderly review
Journal or Publication Title: Current Medical Research and Opinion
Publisher: Taylor & Francis Group
ISSN: 0300-7995
DOI / ID Number: 10.1080/03007995.2018.1424624
Copyright Information:

Copyright 2018 Informa UK Limited, trading as Taylor & Francis Group

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