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dc.contributor.authorHalvorsen, Kjell H.
dc.contributor.authorStadeløkken, Torunn
dc.contributor.authorGarcia, Beate Hennie
dc.date.accessioned2019-11-19T12:38:51Z
dc.date.available2019-11-19T12:38:51Z
dc.date.issued2019-11-05
dc.description.abstract<p><i>Background - </i>The provision of responsible medication therapy to old nursing home residents with comorbidities is a difficult task and requires extensive knowledge about optimal pharmacotherapy for different conditions. We describe a stepwise pharmacist-led medication review service in combination with an interdisciplinary team collaboration in order to identify, resolve, and prevent medication related problems (MRPs). <p><i>Methods - </i>The service included residents from four rural Norwegian nursing homes during August 2016–January 2017. All residents were eligible if they (or next of kin) supplied oral consent. The interdisciplinary medication review service comprised four steps: (1) patient and medication history taking; (2) systematic medication review; (3) interdisciplinary case conference; and (4) follow-up of pharmaceutical care plan. The pharmacist collected information about previous and present medication use, and clinical and laboratory values necessary for the medication review. The nurses collected information about possible symptoms related to adverse drug reactions. The pharmacist conducted the medication reviews, identified medication-related problems (MRPs) which were discussed at case conferences with the responsible physician and the responsible nurses. The main outcome measures were number and types of MRPs, percentage agreement between pharmacists and physicians and factors associated with MRPs. <p><i>Results - </i>The service was delivered for 151 (94%) nursing home residents. The pharmacist identified 675 MRPs in 146 (97%) medication lists (mean 4.0, SD 2.6, range 0–13). The MRPs most frequently identified concerned ‘unnecessary drug’ (22%), ‘too high dosage’ (17%) and ‘drug interactions’ (16%). The physicians agreed upon 64% of the pharmacist recommendations, and action was taken immediately for 32% of these. We identified no association between the number of MRPs and sex (p = 0.485), but between the number of MRPs, and the number of medications and the individual nursing homes. <p><i>Conclusion - </i>The pharmacist-led medication review service in the nursing homes was highly successfully piloted with many solved and prevented MRPs in interdisciplinary collaboration between the pharmacist, physicians, and nurses. Implementation of this service as a standard in all four nursing homes seems necessary and feasible. If such a service is implemented, effects related to patient outcomes, interdisciplinary collaboration, and health economy should be studied.en_US
dc.descriptionSource at <a href=https://doi.org/10.3390/pharmacy7040148>https://doi.org/10.3390/pharmacy7040148</a>.en_US
dc.identifier.citationHalvorsen, K.H., Stadeløkken, T. & Garcia, B.H. (2019). A Stepwise Pharmacist-Led Medication Review Service in Interdisciplinary Teams in Rural Nursing Homes. <i>Pharmacy, 7</i>(4), 148. https://doi.org/10.3390/pharmacy7040148en_US
dc.identifier.cristinIDFRIDAID 1746877
dc.identifier.doihttps://doi.org/10.3390/pharmacy7040148
dc.identifier.issn2226-4787
dc.identifier.urihttps://hdl.handle.net/10037/16685
dc.language.isoengen_US
dc.publisherMDPIen_US
dc.relation.journalPharmacy
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710::Pharmacology: 728en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710::Farmakologi: 728en_US
dc.subjectVDP::Medical disciplines: 700::Health sciences: 800::Health service and health administration research: 806en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800::Helsetjeneste- og helseadministrasjonsforskning: 806en_US
dc.titleA Stepwise Pharmacist-Led Medication Review Service in Interdisciplinary Teams in Rural Nursing Homesen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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