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Pharmacist‐led medication review in community‐dwelling older patients using the GheOP 3 S‐tool: General practitioners' acceptance and implementation of pharmacists' recommendations

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Abstract
Rationale, aims, and objectives: The Ghent Older People's Prescriptions community Pharmacy Screening (GheOP3S)‐tool was recently developed as an explicit screening tool to detect drug‐related problems (DRPs) and to help in performing medication reviews. In this study, we aimed (a) to describe the characteristics of the detected DRPs and the subsequent pharmacists' recommendations with their acceptance and implementation rate resulting from a pharmacist‐led medication review using the GheOP3S‐tool and (b) to assess the potential impact of the intervention. Method: Prospective observational study in community‐dwelling older patients (70 years or older, using five or more medications). Community pharmacists performed medication reviews resulting in the documentation of “GheOP3S‐related DRPs” and “other DRPs” with corresponding pharmacists' recommendations. Acceptance was recorded during face‐to‐face pharmacist‐general practitioner (GP) meetings. Implementation was assessed after a 3‐month follow‐up by consulting the electronic pharmacy record, the patient, and/or GP. The potential impact on the number of medications, the number of “GheOP3S‐related DRPs”, the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI), and medication costs was assessed by a pre‐post comparison of the patients' medication lists. Results: Twenty‐one pharmacists detected 470 DRPs with a median (IQR) of 6 (4‐8) per patient in 75 patients (about half “GheOP3S‐related DRPs” and half “other DRPs”). Most prevalent recommendations were stopping (22.9%) and substituting (18.9%) medication. Overall acceptance was 66.9%. At follow‐up, 42.9% of all recommendations were implemented. The number of GheOP3S‐criteria (P < .001) and the DBI scores (P = .033) significantly differed from baseline. This was not the case for the number of chronic medications and medication costs. Conclusions: This study demonstrates a relatively high acceptance of pharmacists' recommendations, although implementation could be improved. Pharmacist‐led medication reviews with multidisciplinary meetings using the GheOP3S‐tool can have a potential impact on the number of DRPs and the anticholinergic and sedative burden of patients.
Keywords
community pharmacist, Drug Burden Index, drug‐related problem, elderly, medication review

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MLA
Foubert, Katrien et al. “Pharmacist‐led Medication Review in Community‐dwelling Older Patients Using the GheOP  3 S‐tool: General Practitioners’ Acceptance and Implementation of Pharmacists' Recommendations.” Journal of Evaluation in Clinical Practice (2019): n. pag. Print.
APA
Foubert, Katrien, Mehuys, E., Maesschalck, J., De Wulf, I., Wuyts, J., Foulon, V., Lelubre, M., et al. (2019). Pharmacist‐led medication review in community‐dwelling older patients using the GheOP  3 S‐tool: General practitioners’ acceptance and implementation of pharmacists' recommendations. Journal of Evaluation in Clinical Practice.
Chicago author-date
Foubert, Katrien, Els Mehuys, Joris Maesschalck, Isabelle De Wulf, Joke Wuyts, Veerle Foulon, Mélanie Lelubre, et al. 2019. “Pharmacist‐led Medication Review in Community‐dwelling Older Patients Using the GheOP  3 S‐tool: General Practitioners’ Acceptance and Implementation of Pharmacists' Recommendations.” Journal of Evaluation in Clinical Practice.
Chicago author-date (all authors)
Foubert, Katrien, Els Mehuys, Joris Maesschalck, Isabelle De Wulf, Joke Wuyts, Veerle Foulon, Mélanie Lelubre, Carine De Vriese, Annemie Somers, Mirko Petrovic, and Koen Boussery. 2019. “Pharmacist‐led Medication Review in Community‐dwelling Older Patients Using the GheOP  3 S‐tool: General Practitioners’ Acceptance and Implementation of Pharmacists' Recommendations.” Journal of Evaluation in Clinical Practice.
Vancouver
1.
Foubert K, Mehuys E, Maesschalck J, De Wulf I, Wuyts J, Foulon V, et al. Pharmacist‐led medication review in community‐dwelling older patients using the GheOP  3 S‐tool: General practitioners’ acceptance and implementation of pharmacists' recommendations. Journal of Evaluation in Clinical Practice. 2019;
IEEE
[1]
K. Foubert et al., “Pharmacist‐led medication review in community‐dwelling older patients using the GheOP            3            S‐tool: General practitioners’ acceptance and implementation of pharmacists’ recommendations,” Journal of Evaluation in Clinical Practice, 2019.
@article{8623805,
  abstract     = {Rationale, aims, and objectives: The Ghent Older People's Prescriptions community Pharmacy Screening (GheOP3S)‐tool was recently developed as an explicit screening tool to detect drug‐related problems (DRPs) and to help in performing medication reviews. In this study, we aimed (a) to describe the characteristics of the detected DRPs and the subsequent pharmacists' recommendations with their acceptance and implementation rate resulting from a pharmacist‐led medication review using the GheOP3S‐tool and (b) to assess the potential impact of the intervention.
Method: Prospective observational study in community‐dwelling older patients (70 years or older, using five or more medications). Community pharmacists performed medication reviews resulting in the documentation of “GheOP3S‐related DRPs” and “other DRPs” with corresponding pharmacists' recommendations. Acceptance was recorded during face‐to‐face pharmacist‐general practitioner (GP) meetings. Implementation was assessed after a 3‐month follow‐up by consulting the electronic pharmacy record, the patient, and/or GP. The potential impact on the number of medications, the number of “GheOP3S‐related DRPs”, the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI), and medication costs was assessed by a pre‐post comparison of the patients' medication lists.
Results: Twenty‐one pharmacists detected 470 DRPs with a median (IQR) of 6 (4‐8) per patient in 75 patients (about half “GheOP3S‐related DRPs” and half “other DRPs”). Most prevalent recommendations were stopping (22.9%) and substituting (18.9%) medication. Overall acceptance was 66.9%. At follow‐up, 42.9% of all recommendations were implemented. The number of GheOP3S‐criteria (P < .001) and the DBI scores (P = .033) significantly differed from baseline. This was not the case for the number of chronic medications and medication costs.
Conclusions: This study demonstrates a relatively high acceptance of pharmacists' recommendations, although implementation could be improved. Pharmacist‐led medication
reviews with multidisciplinary meetings using the GheOP3S‐tool can have a potential impact on the number of DRPs and the anticholinergic and sedative burden
of patients.},
  author       = {Foubert, Katrien and Mehuys, Els and Maesschalck, Joris and De Wulf, Isabelle and Wuyts, Joke and Foulon, Veerle and Lelubre, Mélanie and De Vriese, Carine and Somers, Annemie and Petrovic, Mirko and Boussery, Koen},
  issn         = {1356-1294},
  journal      = {Journal of Evaluation in Clinical Practice},
  keywords     = {community pharmacist,Drug Burden Index,drug‐related problem,elderly,medication review},
  language     = {eng},
  title        = {Pharmacist‐led medication review in community‐dwelling older patients using the GheOP            3            S‐tool: General practitioners' acceptance and implementation of pharmacists' recommendations},
  url          = {http://dx.doi.org/10.1111/jep.13241},
  year         = {2019},
}

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