Programme no. 262-P
Medication reviews in elderly primary care patients - the medication review process
Nina Viberg1, Patrik Midlöv2, Cecilia Lenander*3, Åsa Bondesson4
1Department of Public Health Sciences,Karolinska Institutet,Stockholm,Sweden, 2Department of Clinical Sciences in Malmö,Lunds Universitet,Malmö,Sweden, 3Department of Clinical Sciences in Malmö,Lunds Universitet,Malmö,Sweden, 4Department of Medicines Management and Informatics,Region Skåne,Malmö,Sweden
* = Presenting author
Objectives: To examine the process of multi-professional medication reviews performed on elderly living either in nursing homes or in ordinary homes with home care in Skåne.
Background: The elderly population is increasing worldwide and many of these senoirs have multiple diseases. Drug use in the elderly population is extensive and use of potential inappropriate medications (PIMs) is common, increasing the risk for drug-related problems (DRPs). Medication review is a method to improve drug therapy by identifying, preventing and solving DRPs.
Results: A total of 2143 medication reviews was performed. Mean age of the patients was 87.6 years (SD 5.8), 72% was women and 89% was living in nursing homes. The participants used on average 11.3 drugs/patient (SD 4.6) and 84% had at least 1 DRP, giving a mean of a 2.7 DRPs/patient. The most common DRPs were unecessary drug therapy (39%), dosage too high (20%) and wrong drug (20%). Patients with ≥1 PIM was significantly reduced from 20.2% before medication review to 10.5% after (p<0.001). A significant reduction in patients with ≥3 psychotropics was also seen, from 23.2% to 17.6% (p<0.001). More patients living at home with home care used ≥3 psychotropics (24%) than did patients in nursing homes (13%) (p<0.001).
Material/Methods: A descriptive retrospective analysis was carried out for patients receiving medication reviews during 2011-2012. Included patients were aged ≥75 years. Documented DRPs were described in aspects of identification, pharmacists’ recommendation to physician, physicians’ acceptance and intervention follow-up. Usage of ≥3 psychotropics and PIMs at baseline and after medication review is also analysed.
Conclusion: Potenital inappropriate medications are common in elderly both at nursing homes and in home care. Medication reviews is a possible way to affect this.
Points for discussion:
Medication reviews in primary care
- For all patients?
- Certain groups?
- How often?
- Ways to improve medication reviews?