Background To improve medicinal treatment management, we decided to review prescriptions in a long term care unit (LTCU), because elderly patients are at higher risk of adverse drugs events. Firstly, they benefit from entrance medicines reconciliation (MedRec) but this can be very difficult with poor efficiency. Indeed, for these patients, questioning is difficult and their pharmacist or general practitioner are not informative because multiple hospitalisations results in loss of medical information. Secondly, it was decided to start periodical medication reviews (MedRev) in association with a physician/pharmacist to evaluate the efficiency of therapeutic medications.
Purpose The aim of this study was to evaluate the efficiency of this new activity and physician acceptation to improve appreciation of MedRev.
Material and methods Only patients in the LTCU were selected; MedRev is performed quarterly for each department. The LTCU covers 4 departments. Recorded information was ATC class, and type and number of pharmaceutical interventions (PI). Three tools were used: PAPA Guide, Laroche and STOPP/START lists.
Results 2 departments benefited from this MedRev (34 patients). The average number of PI per patient was 1.3, with 47% acceptance rate. PI performed concerned mainly drugs of N ATC class (64%, nervous system medicines) and then drugs of A ATC class (28%, digestive system medicines). These PI were dose reduction in 58% and discontinuation in 38%. Whereas 60% of PI offering dose reduction were accepted, only 20% of PI regarding discontinuation were accepted. For medicines ATC A, 67% of the IP were accepted and only 41% of IP regarding ATC N drugs were followed.
Conclusion It seems necessary to continue this work, which allows the creation of close links with doctors to discuss and optimise each prescription. High level of physician approbation shows the interest in the MedRev. It also helps pharmacists to improve their impact as members of the patient care team.
References and/or acknowledgements Physician of LTCU.
No conflict of interest
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