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The Role of the Pharmacist in Optimizing Pharmacotherapy in Older People

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Abstract

Prescription of medicines is a fundamental component of the care of older people, but evidence suggests that pharmacotherapy in this population is often inappropriate. Pharmacists have been involved in different approaches for the optimization of prescribing and rational medication use in older people. This article describes the different models of care in which pharmacists are involved in the optimization of pharmacotherapy in older people, and reviews the impact of these approaches on both process and outcome measures. The provision of pharmaceutical care, medication reviews and educational interventions by pharmacists in the nursing home, ambulatory and acute care settings are discussed. We selected systematic reviews, reviews and original studies, and for the latter, we focused more specifically on European publications published between 2001 and 2011.

From the literature reviewed, it is clear that when pharmacists play a proactive role in performing medication reviews and in the active education of other healthcare professionals, pharmacotherapy for older patients is improved. However, the evidence of the impact of pharmacists’ interventions on health outcomes, quality of life or cost effectiveness of care is mixed. Better results have been reported when pharmacists are skilled and work in the context of a multidisciplinary team. Opportunities remain for multicentre, European-based, pharmacist-intervention trials in all settings, to determine the effectiveness and economic benefit of pharmacist involvement in the optimization of pharmacotherapy in older people.

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Acknowledgements

This paper was written by the three authors stated above without any financial support. Research work of Dr Fialová, Department of Geriatrics and Gerontology, Charles University in Prague, Czech Republic, was supported by grants IGA MZ č.j. 10-029-4/2008.

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Authors and Affiliations

  1. Louvain Drug Research Institute, Clinical Pharmacy Research Group - Av E Mounier, Université catholique de Louvain, 73 B1.72.02 - 1200, Brussels, Belgium

    Anne Spinewine

  2. Université catholique de Louvain - CHU Mont-Godinne, Yvoir, Belgium

    Anne Spinewine

  3. Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic

    Daniela Fialová

  4. Department of Social and Clinical Pharmacy, Faculty of Pharmacy, Charles University, Hradec Králové, Czech Republic

    Daniela Fialová

  5. Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland

    Stephen Byrne

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  1. Anne Spinewine
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  2. Daniela Fialová
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  3. Stephen Byrne
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Correspondence to Anne Spinewine.

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Spinewine, A., Fialová, D. & Byrne, S. The Role of the Pharmacist in Optimizing Pharmacotherapy in Older People. Drugs Aging 29, 495–510 (2012). https://doi.org/10.2165/11631720-000000000-00000

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