Abstract
Background There is a growing body of evidence which supports that a pharmacist conducted medication review increases the health outcomes for patients. A pharmacist integrated into a primary care medical centre may offer many potential advantages in conducting medication reviews in this setting however research describing this is presently limited. Objective To compare medication review reports conducted by pharmacists practicing externally to a medical centre to those medication review reports conducted by an integrated practice pharmacist. The secondary objective was to compare medication review reports conducted by pharmacists in the patient’s home to those conducted in the medical centre. Setting A primary care medical centre, Brisbane, Australia Method A retrospective analysis of pharmacist conducted medication reviews prior to and after the integration of a pharmacist into a medical centre. Main outcome measures Types of drug related problems identified by the Pharma cists, recommended intervention for drug related problems made by the pharmacist, and the extent of implementation of pharmacist recommendations by the general practitioner. Results The primary drug related problem reported in the practice pharmacist phase was Additional therapy required as compared to Precautions in the external pharmacist phase. The practice pharmacist most frequently recommended to add drug with Additional monitoring recommended most often in the external pharmacists. During the practice pharmacist phase 71 % of recommendations were implemented and was significantly higher than the external pharmacist phase with 53 % of recommendations implemented (p < 0.0001). Two of the 23 drug related problem domains differed significantly when comparing medication reviews conducted in the patient’s home to those conducted in the medical centre.
Similar content being viewed by others
References
The Pharmacy Guild of Australia. Home Medicines Reviews. [Internet] Canberra: The Pharmacy Guild of Australia; 2011 [28 May 2011]; Available from: http://www.guild.org.au/The_Guild/tab-Pharmacy_Services_and_Programs/Medications_Management/Home_Medicines_Review/Home+Medicines+Reviews.page?.
Campbell Research and Consulting Pty Ltd. Home medicines review program qualitative research project final report. Canberra, Department of Health & Ageing; 2008.
Ackermann E, Williams I, Freeman C. Pharmacists in general practice–a proposed role in the multidisciplinary team. Aust Fam Physician. 2010;39(3):163–4.
Stafford L, Peterson GM, Bereznicki LR, Jackson SL, van Tienen EC, Angley MT, et al. Clinical outcomes of a collaborative, home-based post discharge warfarin management service. Ann Pharmacother. 2011;45(3):325–34.
Roughead EE, Barratt JD, Ramsay E, Pratt N, Ryan P, Peck R, et al. The effectiveness of collaborative medicine reviews in delaying time to next hospitalization for patients with heart failure in the practice setting: results of a cohort study. Circ Heart Fail. 2009;2(5):424–8.
Stafford A, Tenni P, Peterson G, Doran C, Kelly W. VALMER (the Economic Value of Home Medication Reviews). Canberra, The Pharmacy Guild of Australia;2010. Report No.: IIG-021.
Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. Br J Clin Pharmacol. 2008;65(3):303–16.
Niquille A, Bugnon O. Relationship between drug-related problems and health outcomes: a cross-sectional study among cardiovascular patients. Pharm World Sci. 2010;32(4):512–9.
Castelino RL, Bajorek BV, Chen TF. Retrospective evaluation of home medicines review by pharmacists in older australian patients using the medication appropriateness index. Ann Pharmacother. 2010;44(12):1922–9.
Sorensen L, Stokes JA, Purdie DM, Woodward M, Elliott R, Roberts MS. Medication reviews in the community: results of a randomized, controlled effectiveness trial. Br J Clin Pharmacol. 2004;58(6):648–64.
Vinks TH, Egberts TC, de Lange TM, de Koning FH. Pharmacist-based medication review reduces potential drug-related problems in the elderly: the SMOG controlled trial. Drugs Aging. 2009;26(2):123–33.
Krska J, Cromarty JA, Arris F, Jamieson D, Hansford D, Duffus PR, et al. Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care. Age Ageing. 2001;30(3):205–11.
The Pharmacy Guild of Australia. Program specific guidelines: home medicines review. [Online] Canberra2011 [09/11/2011]; Available from: http://www.5cpa.com.au/iwov-resources/documents/5CPA/Initiatives/Medication_Management/Home_Medicines_Review/HMRProgramSpecificGuidelinesOct2011.pdf.
Freeman C, Cottrell WN, Kyle G, Williams I, Nissen L. does a primary care practice pharmacist improve the timeliness and completion of medication management reviews? International Journal of Pharmacy Practice. 2012;(in Press).
Mitchell G, Senior H, Foster M, Williams I, Chaffey J, Chambers R, et al. The role of allied health in the management of complex conditions in a comprehensive primary care setting. Canberra: Australian Primary Health Care Research Institute; 2012.
Bennett A, Smith C, Chen T, Johnson S, R H. A comparative study of two collaborative models for the provision of domiciliary medication review: St George Canterbury Medico/Pharmacy Project - Executive Report. Sydney, Australia University of Sydney and St George Division of General Practice; 2000; Available from: http://beta.guild.org.au/uploadedfiles/Medication_Management_Reviews/Overview/St_George_Executive_summary_report_2000.doc.
Pharmaceutical Care Network Europe. The PCNE Classification V 6.2. [Online]: Pharmaceutical Care Network Europe Foundation; 2010 [07/11/2011]; Available from: http://www.pcne.org/sig/drp/documents/PCNE%20classification%20V6-2.pdf.
Stafford AC, Tenni PC, Peterson GM, Jackson SL, Hejlesen A, Villesen C, et al. Drug-related problems identified in medication reviews by Australian pharmacists. Pharm World Sci. 2009;31(2):216–23.
Castelino RL, Bajorek BV, Chen TF. Are interventions recommended by pharmacists during Home Medicines Review evidence-based? J Eval Clin Pract. 2011;17(1):104–10.
Uribis Keys Young. Evaluation of the Home Medicines Review program (Pharmacy Component). [Online] Canberra: Pharmacy Guild of Australia; 2005 [15/11/2011]; Available from: http://beta.guild.org.au/uploadedfiles/Medication_Management_Reviews/Overview/Urbis%20Keys%20Young%20evaluation.pdf.
Acknowledgments
The authors would like to acknowledge the assistance of Jenny Roberts and Sarah Parker in the coding and collation of data.
Funding
None.
Conflicts of interest
The Authors declare that they have no conflicts of interest to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Freeman, C.R., Cottrell, W.N., Kyle, G. et al. An evaluation of medication review reports across different settings. Int J Clin Pharm 35, 5–13 (2013). https://doi.org/10.1007/s11096-012-9701-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11096-012-9701-8