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Home-Based Comprehensive Medication Reviews: Pharmacist's Impact on Drug Therapy Problems in Geriatric Patients

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OBJECTIVE: To evaluate the effects of pharmacist-conducted, home-based comprehensive medication reviews (CMRs) on drug therapy problems (DTPs) in geriatric patients.

DESIGN: Pre-/postintervention study.

SETTING: Grocery store chain affiliated with three independent living facilities.

PARTICIPANTS: Twenty-five older adults using pharmacy delivery services for at least three chronic medications.

INTERVENTION: A pharmacist conducted a home-based CMR for each participant. DTPs were identified across 13 categories. Patients received a medication action plan post-CMR. A follow-up patient phone call was completed two weeks following the appointment. Patient profiles were reviewed for three months postintervention for changes in DTPs.

MAIN OUTCOME MEASURES: Changes in DTPs per patient and changes in five Centers for Medicare & Medicaid Services triple-weighted Star Rating performance measures.

RESULTS: The average DTPs identified per patient were reduced from 3.4 ± 2.06 to 1.48 ± 1.68 (P < 0.05) DTPs three months postintervention. The most common categories identified—nonadherence and incorrect administration/ technique—were significantly reduced (P = 0.012 and P = 0.010, respectively). One Star Rating performance measure significantly improved: 68% of patients taking hypertension medications were adherent at baseline and 91% were adherent three months post-CMR (P = 0.016).

CONCLUSION: Pharmacist-provided, home-based CMRs reduced the average number of DTPs per patient. The most common categories of DTPs identified—nonadherence and incorrect administration/technique—were reduced postintervention.
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Keywords: CHRONIC DISEASE; COMPREHENSIVE MEDICATION REVIEW; DRUG THERAPY PROBLEM; GERIATRICS; MEDICATION THERAPY MANAGEMENT; NONADHERENCE; PHARMACIST; STAR RATING

Document Type: Research Article

Affiliations: Balls Food Stores/Price Chopper, Overland Park, Kansas, USA

Publication date: 01 October 2016

More about this publication?
  • The Consultant Pharmacist® is the official peer-reviewed journal of the American Society of Consultant Pharmacists. It is dedicated exclusively to the medication needs of the elderly in all settings, including adult day care, ambulatory care, assisted living, community, hospice, and nursing facilities. This award-winning journal is a member benefit of ASCP. Individuals who are not members and wish to receive The Consultant Pharmacist® will want to consider joining ASCP.
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