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Medication management among home-dwelling older patients with chronic diseases: possible roles for community pharmacists

Els Mehuys UGent, Laurence Dupond UGent, Mirko Petrovic UGent, Thierry Christiaens UGent, Lucas Van Bortel UGent, Els Adriaens UGent, Leen De Bolle UGent, Inge Van Tongelen UGent, Jean Paul Remon UGent and Koen Boussery UGent (2012) JOURNAL OF NUTRITION HEALTH & AGING. 16(8). p.721-726
abstract
Objective : To describe medication management among home-dwelling older adults. These data should allow us to identify potential problems and to indicate target areas for community pharmacist intervention. Design : Cross-sectional observational study. Setting : Community pharmacies (n=86) in Belgium. Participants : Home-dwelling older adults using at least one chronic medicine (n=338). Measurements : Data on drug use were taken from the electronic pharmacy databases, while drug adherence was measured by pill count, self-report and estimation by GP and pharmacist. Drug knowledge and practical drug management capacity were assessed by patient interview and questionnaire, respectively. Results : The study population (n=338) used a median of 5 chronic drugs per patient. Half of our sample (n=169) used psychotropic medication chronically, mainly benzodiazepines. In 100 patients (29.6%) at least one drug-drug interaction of potential clinical significance was observed. The overall mean adherence per patient was very high (98.1%), but 39.6% of individuals was underadherent with at least one medication. Seventy-six % of patients had an acceptable knowledge of the indication for at least 75% of their medication. In nearly 15 % of the study population cognitive impairment was suspected by the Mini-Cog Test. The participants reported several practical problems with drug taking; difficulties with vision (32.0%), blister opening (12.1%), tablet swallowing (14.8%), tablet splitting (29.7% [represents % of patients who have to split tablets]) and distinction between different drug packages (23.4%). Conclusion : This study identified the following aspects of medication management by home-dwelling older adults that could be improved by pharmaceutical care sendces; (i) assistance of cognitively impaired patients, (ii) management of practical drug taking problems, (iii) DDI screening, (iv) drug adherence, and (v) chronic benzodiazepine use.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
medication management, Home-dwelling elderly, community pharmacy, pharmaceutical care, DRUG-DRUG INTERACTIONS, RANDOMIZED CONTROLLED-TRIAL, BENZODIAZEPINE USE, ELDERLY-PATIENTS, PRIMARY-CARE, IMPROVE MEDICATION, UNITED-STATES, POPULATION, PRESCRIPTION, MEDICINES
journal title
JOURNAL OF NUTRITION HEALTH & AGING
J. Nutr. Health Aging
volume
16
issue
8
pages
721 - 726
Web of Science type
Article
Web of Science id
000310328000008
JCR category
NUTRITION & DIETETICS
JCR impact factor
2.394 (2012)
JCR rank
31/75 (2012)
JCR quartile
2 (2012)
ISSN
1279-7707
DOI
10.1007/s12603-012-0028-x
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1920063
handle
http://hdl.handle.net/1854/LU-1920063
date created
2011-10-03 21:00:41
date last changed
2013-02-13 13:25:15
@article{1920063,
  abstract     = {Objective : To describe medication management among home-dwelling older adults. These data should allow us to identify potential problems and to indicate target areas for community pharmacist intervention. 
Design : Cross-sectional observational study. 
Setting : Community pharmacies (n=86) in Belgium. 
Participants : Home-dwelling older adults using at least one chronic medicine (n=338). 
Measurements : Data on drug use were taken from the electronic pharmacy databases, while drug adherence was measured by pill count, self-report and estimation by GP and pharmacist. Drug knowledge and practical drug management capacity were assessed by patient interview and questionnaire, respectively. 
Results : The study population (n=338) used a median of 5 chronic drugs per patient. Half of our sample (n=169) used psychotropic medication chronically, mainly benzodiazepines. In 100 patients (29.6\%) at least one drug-drug interaction of potential clinical significance was observed. The overall mean adherence per patient was very high (98.1\%), but 39.6\% of individuals was underadherent with at least one medication. Seventy-six \% of patients had an acceptable knowledge of the indication for at least 75\% of their medication. In nearly 15 \% of the study population cognitive impairment was suspected by the Mini-Cog Test. The participants reported several practical problems with drug taking; difficulties with vision (32.0\%), blister opening (12.1\%), tablet swallowing (14.8\%), tablet splitting (29.7\% [represents \% of patients who have to split tablets]) and distinction between different drug packages (23.4\%). 
Conclusion : This study identified the following aspects of medication management by home-dwelling older adults that could be improved by pharmaceutical care sendces; (i) assistance of cognitively impaired patients, (ii) management of practical drug taking problems, (iii) DDI screening, (iv) drug adherence, and (v) chronic benzodiazepine use.},
  author       = {Mehuys, Els and Dupond, Laurence and Petrovic, Mirko and Christiaens, Thierry and Van Bortel, Lucas and Adriaens, Els and De Bolle, Leen and Van Tongelen, Inge and Remon, Jean Paul and Boussery, Koen},
  issn         = {1279-7707},
  journal      = {JOURNAL OF NUTRITION HEALTH \& AGING},
  keyword      = {medication management,Home-dwelling elderly,community pharmacy,pharmaceutical care,DRUG-DRUG INTERACTIONS,RANDOMIZED CONTROLLED-TRIAL,BENZODIAZEPINE USE,ELDERLY-PATIENTS,PRIMARY-CARE,IMPROVE MEDICATION,UNITED-STATES,POPULATION,PRESCRIPTION,MEDICINES},
  language     = {eng},
  number       = {8},
  pages        = {721--726},
  title        = {Medication management among home-dwelling older patients with chronic diseases: possible roles for community pharmacists},
  url          = {http://dx.doi.org/10.1007/s12603-012-0028-x},
  volume       = {16},
  year         = {2012},
}

Chicago
Mehuys, Els, Laurence Dupond, Mirko Petrovic, Thierry Christiaens, Lucas Van Bortel, Els Adriaens, Leen De Bolle, Inge Van Tongelen, Jean Paul Remon, and Koen Boussery. 2012. “Medication Management Among Home-dwelling Older Patients with Chronic Diseases: Possible Roles for Community Pharmacists.” Journal of Nutrition Health & Aging 16 (8): 721–726.
APA
Mehuys, E., Dupond, L., Petrovic, M., Christiaens, T., Van Bortel, L., Adriaens, E., De Bolle, L., et al. (2012). Medication management among home-dwelling older patients with chronic diseases: possible roles for community pharmacists. JOURNAL OF NUTRITION HEALTH & AGING, 16(8), 721–726.
Vancouver
1.
Mehuys E, Dupond L, Petrovic M, Christiaens T, Van Bortel L, Adriaens E, et al. Medication management among home-dwelling older patients with chronic diseases: possible roles for community pharmacists. JOURNAL OF NUTRITION HEALTH & AGING. 2012;16(8):721–6.
MLA
Mehuys, Els, Laurence Dupond, Mirko Petrovic, et al. “Medication Management Among Home-dwelling Older Patients with Chronic Diseases: Possible Roles for Community Pharmacists.” JOURNAL OF NUTRITION HEALTH & AGING 16.8 (2012): 721–726. Print.