Changes in medicine prescription following a medication review in older high-risk patients with polypharmacy

Marian Z.M. Hurmuz, Sarah I.M. Janus, Jeannette G. van Manen* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)
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Abstract

Background: The more (inappropriate) drugs a patient uses, the higher the risk of drug related problems. To reduce these risks, medication reviews can be performed.

Objective: To report changes in the prescribed number of (potentially inappropriate) drugs before and after performing a medication review in high-risk polypharmacy patients. A secondary objective was to study reasons for continuing potentially inappropriate drugs (PIDs). Setting Dutch community pharmacy and general medical practice.

Methods: A retrospective longitudinal intervention study with a pre-test/post-test design and follow-up of 1 week and 3 months was performed. The study population consisted of 126 patients with polypharmacy and with additional risk for drug related problems that underwent a medication review in five community pharmacies. The medication review was performed by the pharmacist in close cooperation with the general practitioner of each corresponding patient.

Main outcome measure: Number of (potentially inappropriate) drugs, and appropriateness of prescribed medicines.

Results: The average number of drugs a patient used 1 day before the review was 8.7 (SD = 2.9), which decreased (p < 0.05) to 8.3 (SD = 2.7) 1 week after the review, and to 8.4 (SD = 2.6) 3 months after the review. The average number of PIDs was initially 0.6 (SD = 0.8) per patient and decreased to 0.4 (SD = 0.6, p < 0.05). Twenty-two of the 241 initial drug changes (9%) were deprescribed during follow-up. Registered reasons for continuing PIDs are clinical or patients’ preferences.

Conclusions: Performing medication reviews in polypharmacy patients seems useful to continue at least in high-risk patients in The Netherlands. The time-consuming reviews could be limited to patients who are willing to change their medication.

Original languageEnglish
Pages (from-to)480-487
Number of pages8
JournalInternational Journal of Clinical Pharmacy
Volume40
Issue number2
DOIs
Publication statusPublished - 1 Apr 2018

Keywords

  • UT-Hybrid-D
  • Elderly
  • Medication review
  • Polypharmacy
  • The Netherlands
  • Drug prescription

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