A retrospective study of drug‐related problems in Australian aged care homes: medication reviews involving pharmacists and general practitioners |
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Authors: | Prasad S Nishtala MPharm Andrew J McLachlan PhD J Simon Bell PhD Timothy F Chen PhD |
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Institution: | 1. Researcher,;2. Professor of Pharmacy (Aged Care), Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia and Professor of Pharmacy (Aged Care), Centre for Education and Research on Ageing, Concord Hospital, Concord, NSW, Australia;3. Honorary Associate, Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia, Research Director, Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Finland and Research Director, Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Finland;4. Senior Lecturer, Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia |
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Abstract: | Background Drug‐related problems (DRPs) in Australian aged care homes have been studied previously. However, little is known about the acceptance and implementation of pharmacists' recommendations by general practitioners (GPs) to resolve DRPs. Objectives The primary objective of this study was to investigate the number and nature of DRPs identified by accredited clinical pharmacists. The secondary objective was to study the GP acceptance and implementation of pharmacist recommendations to resolve DRPs. Methods This was a retrospective study of 500 randomly selected, de‐identified medication reviews performed by 10 accredited clinical pharmacists over 6 months across 62 aged care homes. The DRPs identified by pharmacists were subsequently classified by the drugs involved, types of problem (indication, effectiveness and safety) and medical diagnoses of the patient. GP written feedback on the medication review reports determined implementation of pharmacists' recommendations to resolve the DRPs. Results A total of 1433 DRPs were identified in 480 of the 500 residents. Potential DRPs were frequently classified as risk of adverse drug reactions, need for additional monitoring and inappropriate choice of a drug. Alimentary, cardiovascular, central nervous system and respiratory drugs were most frequently implicated, accounting for more than 75% of the DRPs. GPs' acceptance and implementation of pharmacists recommendations were 72.5% (95% CI; 70.2, 74.8) and 58.1% (95% CI; 55.5, 60.6), respectively. Conclusions Over 96% of the residents had potential DRPs identified by pharmacists. GP acceptance of pharmacists' recommendations was independent of the drug category, but not independent of the disease category. |
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Keywords: | accredited clinical pharmacist aged care homes drug‐related problems medication review older people |
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