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Pharmacists' interventions for optimization of medication use in nursing homes : a systematic review

Charlotte Verrue UGent, Mirko Petrovic UGent, Els Mehuys UGent, Jean Paul Remon UGent and Robert Vander Stichele UGent (2009) DRUGS & AGING. 26(1). p.37-49
abstract
The elderly use more medications than younger adults. In addition, the prevalence of inappropriate prescribing is high in nursing homes. The aim of this review was to collect and interpret the results of clinical studies of interventions involving pharmacists aimed at improving the quality of prescribing in nursing homes, and to identify the key elements for a successful intervention. To this end, we searched MEDLINE, International Pharmaceutical Abstracts and EMBASE from January 1987 to May 2008. Studies were selected that (i) involved a pharmacist; (ii). took place in the nursing home setting; (iii) involved residents aged >= 65 years; (iv) included residents with a range of diseases (not targeted at a specific pathology); (v) were controlled trials (randomized or not). The search strategy retrieved eight controlled studies that fitted the inclusion criteria. A meta-analysis was not possible because of the difference in outcomes chosen in the publications. We found mixed evidence for the effectiveness of various interventions by pharmacists on pharmacotherapy in the nursing home setting. Pharmacists can have different roles in the nursing home such as performing regular medication reviews, being an active member of a multidisciplinary team and/or educating physicians, nurses and other nursing home staff about medication use. Our review shows that the available evidence is mixed concerning the effectiveness of interventions by pharmacists on pharmacotherapy in the nursing home setting. At the same time, greater pharmacist involvement has been shown in published studies to increase physicians' and nurses' knowledge and awareness about medication. Evidence is scarce, however, and there is a need for large, well conducted randomized controlled trials in the nursing home setting. Attention should be paid to the choice of outcome measures and to multidisciplinary collaboration when assessing the effects of pharmacists' interventions on medication use in nursing homes.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
keyword
LONG-TERM-CARE, COMMUNITY PHARMACISTS, MANAGEMENT, OUTCOMES, AGED-CARE, FACILITIES, IMPACT, ELDERLY OUTPATIENTS, RANDOMIZED CONTROLLED-TRIAL, OLDER-ADULTS
journal title
DRUGS & AGING
Drugs Aging
volume
26
issue
1
pages
37 - 49
Web of Science type
Review
Web of Science id
000262803300003
JCR category
GERIATRICS & GERONTOLOGY
JCR impact factor
2.209 (2009)
JCR rank
16/40 (2009)
JCR quartile
2 (2009)
ISSN
1170-229X
DOI
10.2165/0002512-200926010-00003
language
English
UGent publication?
yes
classification
A1
id
514056
handle
http://hdl.handle.net/1854/LU-514056
date created
2009-03-04 11:31:03
date last changed
2017-09-14 08:17:31
@article{514056,
  abstract     = {The elderly use more medications than younger adults. In addition, the prevalence of inappropriate prescribing is high in nursing homes. The aim of this review was to collect and interpret the results of clinical studies of interventions involving pharmacists aimed at improving the quality of prescribing in nursing homes, and to identify the key elements for a successful intervention. To this end, we searched MEDLINE, International Pharmaceutical Abstracts and EMBASE from January 1987 to May 2008. Studies were selected that (i) involved a pharmacist; (ii). took place in the nursing home setting; (iii) involved residents aged {\textrangle}= 65 years; (iv) included residents with a range of diseases (not targeted at a specific pathology); (v) were controlled trials (randomized or not). The search strategy retrieved eight controlled studies that fitted the inclusion criteria. A meta-analysis was not possible because of the difference in outcomes chosen in the publications. We found mixed evidence for the effectiveness of various interventions by pharmacists on pharmacotherapy in the nursing home setting. Pharmacists can have different roles in the nursing home such as performing regular medication reviews, being an active member of a multidisciplinary team and/or educating physicians, nurses and other nursing home staff about medication use. Our review shows that the available evidence is mixed concerning the effectiveness of interventions by pharmacists on pharmacotherapy in the nursing home setting. At the same time, greater pharmacist involvement has been shown in published studies to increase physicians' and nurses' knowledge and awareness about medication. Evidence is scarce, however, and there is a need for large, well conducted randomized controlled trials in the nursing home setting. Attention should be paid to the choice of outcome measures and to multidisciplinary collaboration when assessing the effects of pharmacists' interventions on medication use in nursing homes.},
  author       = {Verrue, Charlotte and Petrovic, Mirko and Mehuys, Els and Remon, Jean Paul and Vander Stichele, Robert},
  issn         = {1170-229X},
  journal      = {DRUGS \& AGING},
  keyword      = {LONG-TERM-CARE,COMMUNITY PHARMACISTS,MANAGEMENT,OUTCOMES,AGED-CARE,FACILITIES,IMPACT,ELDERLY OUTPATIENTS,RANDOMIZED CONTROLLED-TRIAL,OLDER-ADULTS},
  language     = {eng},
  number       = {1},
  pages        = {37--49},
  title        = {Pharmacists' interventions for optimization of medication use in nursing homes : a systematic review},
  url          = {http://dx.doi.org/10.2165/0002512-200926010-00003},
  volume       = {26},
  year         = {2009},
}

Chicago
Verrue, Charlotte, Mirko Petrovic, Els Mehuys, Jean Paul Remon, and Robert Vander Stichele. 2009. “Pharmacists’ Interventions for Optimization of Medication Use in Nursing Homes : a Systematic Review.” Drugs & Aging 26 (1): 37–49.
APA
Verrue, C., Petrovic, M., Mehuys, E., Remon, J. P., & Vander Stichele, R. (2009). Pharmacists’ interventions for optimization of medication use in nursing homes : a systematic review. DRUGS & AGING, 26(1), 37–49.
Vancouver
1.
Verrue C, Petrovic M, Mehuys E, Remon JP, Vander Stichele R. Pharmacists’ interventions for optimization of medication use in nursing homes : a systematic review. DRUGS & AGING. 2009;26(1):37–49.
MLA
Verrue, Charlotte, Mirko Petrovic, Els Mehuys, et al. “Pharmacists’ Interventions for Optimization of Medication Use in Nursing Homes : a Systematic Review.” DRUGS & AGING 26.1 (2009): 37–49. Print.