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Covariates that influence the quality of a medication review
  1. Carlota Mestres Gonzalvo1,
  2. Kim P G M Hurkens2,
  3. Hugo A J M de Wit1,
  4. Rob Janknegt1,
  5. Jos M G A Schols3,
  6. Wubbo J Mulder2,
  7. Frans R Verhey4,
  8. Bjorn Winkens5,
  9. Paul-Hugo M van der Kuy1
  1. 1Department of Clinical Pharmacy and Toxicology, Orbis Medical Centre, Sittard, The Netherlands
  2. 2Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
  3. 3Department of General Practice and Department of Health Services Research, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
  4. 4Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg/School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
  5. 5Department of Methodology and Statistics, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
  1. Correspondence to Carlota Mestres Gonzalvo, Department of Clinical Pharmacy and Toxicology, Orbis Medisch Centrum, Dr H. van der Hoffplein 1, Sittard-Geleen 6162 BG, The Netherlands; c.mestresgonzalvo{at}orbisconcern.nl

Abstract

Background Medication reviews are considered to be important to maintain a high quality of pharmacotherapy. However, there is a large variation in the quality of these reviews.

Aim To evaluate the covariates that may lead to high-quality medication reviews and to establish their relative importance.

Design Healthcare professionals, including community pharmacists, hospital pharmacists, nursing home physicians, general practitioners and geriatricians, were recruited in the province of Limburg, The Netherlands.

Method A research group, selected for their expertise in the field of medication reviews, established covariates that could possibly affect the quality of medication reviews. An electronic questionnaire, including these covariates, was developed and was subsequently sent to the participants who rated the covariates using a 10-point scale. Finally, the research group classified the scores. Physicians and pharmacists were evaluated jointly and separately to account for possible differences.

Results 29 out of 49 participants completed the study. 13 covariates were evaluated and their medians and ranges were calculated. The five most important covariates were, from most to less important, knowledge of the indication for the drug, use of guidelines, reviewer's professional field, knowledge of the medical history, and use of laboratory values. Both groups found the indication for the drug the most important covariate.

Conclusions We found that the most relevant covariates that may lead to a high-quality medication review are the drug's indication, use of patients’ medical history, use of guidelines, reviewer's professional field, and use of laboratory values.

  • Aged
  • Decision Support Systems Management
  • Medication Therapy Management
  • Nursing home
  • Polypharmacy

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