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In-hospital medication reviews reduce unidentified drug-related problems

Bondesson, Åsa ÅB LU ; Eriksson, Tommy LU ; Kragh Ekstam, Annika LU ; Holmdahl, Lydia LU ; Midlöv, Patrik LU and Höglund, Peter LU (2013) In European Journal of Clinical Pharmacology 69(3). p.647-655
Abstract
Purpose To examine the impact of a new model of care, in which a clinical pharmacist conducts structured medication reviews and a multi-professional team collates systematic medication care plans, on the number of unidentified DRPs in a hospital setting. Methods In a prospective two-period study, patients admitted to an internal medicine ward at the University Hospital of Lund, Sweden, were included if they were >= 65 years old, used >= 3 medications on a regular basis and had stayed on the ward for >= 5 weekdays. Intervention patients were given the new model of care and control patients received conventional care. DRPs were then retrospectively identified after study completion from blinded patient records for both intervention... (More)
Purpose To examine the impact of a new model of care, in which a clinical pharmacist conducts structured medication reviews and a multi-professional team collates systematic medication care plans, on the number of unidentified DRPs in a hospital setting. Methods In a prospective two-period study, patients admitted to an internal medicine ward at the University Hospital of Lund, Sweden, were included if they were >= 65 years old, used >= 3 medications on a regular basis and had stayed on the ward for >= 5 weekdays. Intervention patients were given the new model of care and control patients received conventional care. DRPs were then retrospectively identified after study completion from blinded patient records for both intervention and control patients. Two pairs of evaluators independently evaluated and classified these DRPs as having been identified/unidentified during the hospital stay and according to type and clinical significance. The primary endpoint was the number of unidentified DRPs, and the secondary endpoints were the numbers of unidentified DRPs within each type and clinical significance category. Results The study included a total of 141 (70 intervention and 71 control) patients. The intervention group benefited from a reduction in the total number of unidentified DRPs per patient during the hospital stay: intervention group median 1 (1st-3rd quartile 0-2), control group 9 (6-13.5) (p < 0.001), and also in the number of medications associated with unidentified DRPs per patient: intervention group 1 (0-2), control group 8 (5-10) (p < 0.001). All sub-categories of DRPs that were frequent in the control group were significantly reduced in the intervention group. Similarly, the DRPs were less clinically significant in the intervention group. Conclusions A multi-professional team, including a clinical pharmacist, conducting structured medication reviews and collating systematic medication care plans proved very effective in reducing the number of unidentified DRPs for elderly in-patients. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Drug-related problem, In-patient, Medication review, Clinical, pharmacist, Multiprofessional team
in
European Journal of Clinical Pharmacology
volume
69
issue
3
pages
647 - 655
publisher
Springer
external identifiers
  • wos:000317335200041
  • scopus:84877130482
ISSN
1432-1041
DOI
10.1007/s00228-012-1368-5
language
English
LU publication?
yes
id
cc3bb5e0-fa68-4408-976c-bb3b79ae840e (old id 3821917)
date added to LUP
2013-07-01 07:00:07
date last changed
2019-02-20 06:22:28
@article{cc3bb5e0-fa68-4408-976c-bb3b79ae840e,
  abstract     = {Purpose To examine the impact of a new model of care, in which a clinical pharmacist conducts structured medication reviews and a multi-professional team collates systematic medication care plans, on the number of unidentified DRPs in a hospital setting. Methods In a prospective two-period study, patients admitted to an internal medicine ward at the University Hospital of Lund, Sweden, were included if they were &gt;= 65 years old, used &gt;= 3 medications on a regular basis and had stayed on the ward for &gt;= 5 weekdays. Intervention patients were given the new model of care and control patients received conventional care. DRPs were then retrospectively identified after study completion from blinded patient records for both intervention and control patients. Two pairs of evaluators independently evaluated and classified these DRPs as having been identified/unidentified during the hospital stay and according to type and clinical significance. The primary endpoint was the number of unidentified DRPs, and the secondary endpoints were the numbers of unidentified DRPs within each type and clinical significance category. Results The study included a total of 141 (70 intervention and 71 control) patients. The intervention group benefited from a reduction in the total number of unidentified DRPs per patient during the hospital stay: intervention group median 1 (1st-3rd quartile 0-2), control group 9 (6-13.5) (p &lt; 0.001), and also in the number of medications associated with unidentified DRPs per patient: intervention group 1 (0-2), control group 8 (5-10) (p &lt; 0.001). All sub-categories of DRPs that were frequent in the control group were significantly reduced in the intervention group. Similarly, the DRPs were less clinically significant in the intervention group. Conclusions A multi-professional team, including a clinical pharmacist, conducting structured medication reviews and collating systematic medication care plans proved very effective in reducing the number of unidentified DRPs for elderly in-patients.},
  author       = {Bondesson, Åsa ÅB and Eriksson, Tommy and Kragh Ekstam, Annika and Holmdahl, Lydia and Midlöv, Patrik and Höglund, Peter},
  issn         = {1432-1041},
  keyword      = {Drug-related problem,In-patient,Medication review,Clinical,pharmacist,Multiprofessional team},
  language     = {eng},
  number       = {3},
  pages        = {647--655},
  publisher    = {Springer},
  series       = {European Journal of Clinical Pharmacology},
  title        = {In-hospital medication reviews reduce unidentified drug-related problems},
  url          = {http://dx.doi.org/10.1007/s00228-012-1368-5},
  volume       = {69},
  year         = {2013},
}