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Effect of pharmacist-led medication review on medication appropriateness in older adults with chronic kidney disease

Tesfaye, WH, Wimmer, BC ORCID: 0000-0003-3166-7126, Peterson, GM ORCID: 0000-0002-6764-3882, Castelino, RL, Jose, M ORCID: 0000-0002-9589-0071, McKercher, C ORCID: 0000-0002-7672-6743 and Zaidi, STR ORCID: 0000-0002-2031-1055 2019 , 'Effect of pharmacist-led medication review on medication appropriateness in older adults with chronic kidney disease' , Journal of Pharmacy Practice and Research , pp. 1-6 , doi: 10.1002/jppr.1539.

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Abstract

This study evaluated the effect of pharmacist-led review on medication appropriateness in 204 older patients with chronic kidneydisease (CKD) admitted to an Australian hospital. Medication appropriateness was evaluated using the Medication AppropriatenessIndex (MAI) prior to medication review, after review (assuming all recommendations were accepted by physicians) and after outcome (acceptance/non-acceptance) of recommendations. Overall, 95 patients (46%) received a medication review by pharmacists. Themedian (interquartile range) MAI score decreased significantly from a baseline of 7 (3–12) to 5 (2–10) after medication review(p < 0.001) and to 6 (2–10) after the outcome of recommendations (p < 0.01). The MAI score also decreased in patients with no medication review by a pharmacist from 6 (3–11) at admission to 5 (2–9) at discharge (p < 0.001). MAI scores declined markedly in people with all pharmacist-conducted medication review recommendations accepted (from 7 to 3; p < 0.05). Reassuringly,hospitalisation alone improved medication appropriateness. However, pharmacist-led medication review can further optimise medication appropriateness in older CKD patients, particularly when the recommendations are implemented.

Item Type: Article
Authors/Creators:Tesfaye, WH and Wimmer, BC and Peterson, GM and Castelino, RL and Jose, M and McKercher, C and Zaidi, STR
Keywords: chronic kidney disease, medication appropriateness, pharmacist, elderly
Journal or Publication Title: Journal of Pharmacy Practice and Research
Publisher: Wiley-Blackwell Publishing Ltd.
ISSN: 1445-937X
DOI / ID Number: 10.1002/jppr.1539
Copyright Information:

© 2019 The Society of Hospital Pharmacists of Australia

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