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Application of the GheOP3S-tool in nursing home residents : acceptance and implementation of pharmacist recommendations

Katrien Foubert (UGent) , Peter Muylaert (UGent) , Els Mehuys (UGent) , Annemie Somers (UGent) , Mirko Petrovic (UGent) and Koen Boussery (UGent)
(2020) ACTA CLINICA BELGICA. 75(6). p.388-396
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Abstract
Background and objective: The prevalence of potentially inappropriate prescribing (PIP) among nursing home (NH) residents is high. This study aimed to investigate the acceptance and implementation of pharmacist recommendations based on a screening tool for PIP, the Ghent Older People's Prescriptions community Pharmacy Screening (GheOP(3)S)-tool. Setting and method: Prospective observational study in NH residents (>= 70 years, using >= 5 medications) with a 3-month follow-up period. A pharmacist screened the medication lists using the GheOP(3)S-tool and formulated recommendations to reduce PIP. The acceptance of recommendations discussed during face-to-face pharmacist-general practitioner (GP) meetings was recorded. Implementation was examined by comparing baseline and follow-up medication lists. A pre-post comparison of the number of chronic medications and GheOP(3)S-criteria; the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI); and medication costs was performed. Results: Screening with the GheOP(3)S-tool resulted in 168 pharmacist recommendations for 50 NH residents, mainly to stop (78.0%) and to substitute (14.3%) medications. Ninety-three % (156/168) of recommendations were considered relevant. GPs acceptance rate was 44.9%. Fifty-four % of all accepted recommendations were implemented. At follow-up, the number of chronic medications (p = 0.007), and DBI scores (p = 0.004) significantly differed from baseline. There was no significant decrease in the number of GheOP(3)S-criteria (p = 0.075) and medication costs (p > 0.05). Conclusion: The acceptance and implementation of pharmacist recommendations were relatively low. Future studies should increase the involvement of patients and all health-care providers. Interdisciplinary collaboration with sufficient education for all disciplines and patients is essential.
Keywords
Potentially inappropriate prescribing, nursing home, medication review, polypharmacy, pharmacist, DRUG BURDEN INDEX, POTENTIALLY INAPPROPRIATE MEDICATIONS, OLDER-PEOPLE, OUTCOMES, CARE, CRITERIA, POLYPHARMACY, REVIEWS, RISK

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MLA
Foubert, Katrien, et al. “Application of the GheOP3S-Tool in Nursing Home Residents : Acceptance and Implementation of Pharmacist Recommendations.” ACTA CLINICA BELGICA, vol. 75, no. 6, 2020, pp. 388–96, doi:10.1080/17843286.2019.1634323.
APA
Foubert, K., Muylaert, P., Mehuys, E., Somers, A., Petrovic, M., & Boussery, K. (2020). Application of the GheOP3S-tool in nursing home residents : acceptance and implementation of pharmacist recommendations. ACTA CLINICA BELGICA, 75(6), 388–396. https://doi.org/10.1080/17843286.2019.1634323
Chicago author-date
Foubert, Katrien, Peter Muylaert, Els Mehuys, Annemie Somers, Mirko Petrovic, and Koen Boussery. 2020. “Application of the GheOP3S-Tool in Nursing Home Residents : Acceptance and Implementation of Pharmacist Recommendations.” ACTA CLINICA BELGICA 75 (6): 388–96. https://doi.org/10.1080/17843286.2019.1634323.
Chicago author-date (all authors)
Foubert, Katrien, Peter Muylaert, Els Mehuys, Annemie Somers, Mirko Petrovic, and Koen Boussery. 2020. “Application of the GheOP3S-Tool in Nursing Home Residents : Acceptance and Implementation of Pharmacist Recommendations.” ACTA CLINICA BELGICA 75 (6): 388–396. doi:10.1080/17843286.2019.1634323.
Vancouver
1.
Foubert K, Muylaert P, Mehuys E, Somers A, Petrovic M, Boussery K. Application of the GheOP3S-tool in nursing home residents : acceptance and implementation of pharmacist recommendations. ACTA CLINICA BELGICA. 2020;75(6):388–96.
IEEE
[1]
K. Foubert, P. Muylaert, E. Mehuys, A. Somers, M. Petrovic, and K. Boussery, “Application of the GheOP3S-tool in nursing home residents : acceptance and implementation of pharmacist recommendations,” ACTA CLINICA BELGICA, vol. 75, no. 6, pp. 388–396, 2020.
@article{8620913,
  abstract     = {{Background and objective: The prevalence of potentially inappropriate prescribing (PIP) among nursing home (NH) residents is high. This study aimed to investigate the acceptance and implementation of pharmacist recommendations based on a screening tool for PIP, the Ghent Older People's Prescriptions community Pharmacy Screening (GheOP(3)S)-tool. Setting and method: Prospective observational study in NH residents (>= 70 years, using >= 5 medications) with a 3-month follow-up period. A pharmacist screened the medication lists using the GheOP(3)S-tool and formulated recommendations to reduce PIP. The acceptance of recommendations discussed during face-to-face pharmacist-general practitioner (GP) meetings was recorded. Implementation was examined by comparing baseline and follow-up medication lists. A pre-post comparison of the number of chronic medications and GheOP(3)S-criteria; the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI); and medication costs was performed. Results: Screening with the GheOP(3)S-tool resulted in 168 pharmacist recommendations for 50 NH residents, mainly to stop (78.0%) and to substitute (14.3%) medications. Ninety-three % (156/168) of recommendations were considered relevant. GPs acceptance rate was 44.9%. Fifty-four % of all accepted recommendations were implemented. At follow-up, the number of chronic medications (p = 0.007), and DBI scores (p = 0.004) significantly differed from baseline. There was no significant decrease in the number of GheOP(3)S-criteria (p = 0.075) and medication costs (p > 0.05). Conclusion: The acceptance and implementation of pharmacist recommendations were relatively low. Future studies should increase the involvement of patients and all health-care providers. Interdisciplinary collaboration with sufficient education for all disciplines and patients is essential.}},
  author       = {{Foubert, Katrien and Muylaert, Peter and Mehuys, Els and Somers, Annemie and Petrovic, Mirko and Boussery, Koen}},
  issn         = {{1784-3286}},
  journal      = {{ACTA CLINICA BELGICA}},
  keywords     = {{Potentially inappropriate prescribing,nursing home,medication review,polypharmacy,pharmacist,DRUG BURDEN INDEX,POTENTIALLY INAPPROPRIATE MEDICATIONS,OLDER-PEOPLE,OUTCOMES,CARE,CRITERIA,POLYPHARMACY,REVIEWS,RISK}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{388--396}},
  title        = {{Application of the GheOP3S-tool in nursing home residents : acceptance and implementation of pharmacist recommendations}},
  url          = {{http://dx.doi.org/10.1080/17843286.2019.1634323}},
  volume       = {{75}},
  year         = {{2020}},
}

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