The status of medication review in addressing drug-related problems of elderly patients in the community / 中国药房

With the increasing aging of our population， the incidence of drug-related problems among elderly patients in the community is gradually increasing. Drug-related problems can lead to an increased incidence of adverse health outcomes such as falls and frailty in elderly patients in the community. Medication review is one of the effective means of addressing drug-related problems. The medication review models in Europe and the United States have been developed for decades to address drug-related problems； medication review model in the United Kingdom focuses on the management of drug therapy for elderly patients in aged care facilities， while the medication review models in the United States and Australia have a broader scope（covering all elderly patients in the community）， and the frequency of medication reviews in the United States and Australia are clearer and more standardized. Compared with the above countries， China’s medication review model has a late start. Our country can learn from the advanced experience of the United Kingdom， the United States， Australia and other countries， actively explore and build a drug review model suitable for China’s national conditions， so as to improve the health level of elderly patients in the community and save social public medical resources.

Impact of pharmacist intervention in patients with Alzheimer's disease

Abstract To assess the therapy relative to indication, effectiveness, safety and adherence in patients with Alzheimer's disease (AD). An interventional, prospective, non-randomized study was conducted in a single secondary care center in Brazil. The pharmacist-led medication therapy management (MTM) was conducted to detect drug-related problems (DRPs) at baseline and after six months of intervention. The health status outcomes (i.e. cognitive screening tests; levels of glucose; total cholesterol; triglycerides; thyroid stimulating hormone; serum free thyroxine and blood pressure) were measured. 66 patients with AD were included, of whom 55 patients completed the follow-up of six months. 36 patients (36/55) were non-adherent to AD drug therapy. Out of detected 166 DRPs, 116 were solved. Four patients were withdrawn from the AD protocol due to resolution of prodromal symptoms. On the conclusion of the study, the MTM improved and controlled blood pressure, glucose, total cholesterol, triglycerides levels (p<0.05). The pharmacist-led MTM was effective in solving 69.8% of DRPs, improving and controlling the clinical parameters evaluated

What Do Older Adults and Their Caregivers in Malaysia Think of Home Medication Review? A Qualitative Inquiry

@#Introduction: Home medication review (HMR) involves a patient-centered approach, extending continuity of care to the community setting with the intention of improving medication use and health outcome. The delivery of HMR services in Malaysia remains limited to urban hospitals and clinics. Current study aimed to explore the perception and acceptability of HMR in older adults. Methods: In-depth individual interviews were conducted among adults aged ≥65 years old, taking ≥5 medications, recruited from geriatrics clinics at a tertiary teaching hospital. Home interviews were conducted among 12 older adults and care givers between April to June 2019. Interviews were audio-taped, transcribed verbatim and analysed through descriptive interpretive approach of qualitative data analysis. Results: HMR provided participants with opportunities to discuss medication-related issues with pharmacists in conducive environments. Pharmacists provided information which improved knowledge on indications, dosages and safe storage of medications through HMR. Participants experienced relief and developed confidence in medication self-management. Conclusion: The importance of follow-up visits to ensure adequate monitoring and continuity of care were emphasized. Larger quantitative studies are required to determine the clinical impact and cost-effectiveness of HMR to justify the implementation and expansion of this service

Development and validation of the Vi-Med® tool for medication review

Clinical pharmacy practice in Vietnam is unregulated by standard procedures, thus motivating this study, whichdeveloped and validated a tool called Vi-Med® for use in supporting medication review (MR) in Vietnamese hospitals.Six clinical pharmacists from six hospitals used the tool, which comprises three forms: Form 1 for the collectionof patient information, Form 2 for the implementation of MR, and Form 3 for the documentation of pharmacistinterventions (PIs). The tool also comes with eight pre-identified drug-related problems (DRPs) and seven PIs.The pharmacists were asked to categorize 30 PI-associated scenarios under appropriate DRPs and correspondinginterventions. Concordance among the pharmacists was assessed on the basis of agreement level (%) and Cohen’skappa (κ). We also evaluated the user-friendliness of the tool using a four-point Likert scale. Concordance in thepanel with respect to DRPs and PIs was substantial (κ = 0.76 and 80.4% agreement) and almost perfect (κ = 0.83 and87.6% agreement), respectively. All the experts were satisfied with the structure and content of Vi-Med®. Five of themevaluated the tool as very suitable, very useful, and definitely fitting for everyday use. Vi-Med® satisfactorily achievedconsistency and user-friendliness, enabling its use in daily clinical pharmacy practice.

Impact of hospital pharmacist-led home medication review program for people with schizophrenia: A prospective study from Malaysia

This study was to evaluate the impact of hospital pharmacist-led home medication review (HMR) program onmedication adherence, knowledge toward antipsychotic drugs, and quality of life among people with schizophrenia.This was a prospective longitudinal study conducted from October 2012 to December 2013. This study involved 133people with schizophrenia under the care of the home care team in Hospital Bahagia Ulu Kinta Hospital, Malaysia.Upon attaining written informed consent, subjects were home visited after 1, 3, and 6 months by the pharmacist toperform a comprehensive medication review. Friedman analysis of variance test was used to compare the differencesof the patients’ medication adherence, knowledge of antipsychotic treatment, and quality of life at baseline and eachfollow-up visit. Subjects had a significant improvement on medication adherence as shown by the mean medicationadherence rating scale scores (baseline: 8.42 ± 1.40 vs. sixth month: 9.47 ± 1.02; p < 0.001) and mean pill countpercentage (baseline: 56.68% ± 39.43% vs. sixth month: 90.37% ± 15.19%; p < 0.001). Subjects’ mean knowledgescore on antipsychotics were improved significantly with the HMR program (baseline: 5.56 ± 1.51 vs. sixth month:7.65 ± 0.60; p < 0.001). Regarding the subject’s quality of life, the “social” and the “family” components of theSheehan disability scale demonstrated significant improvement (p < 0.001). However, the improvement of the “work”component and overall quality of life were not statistically significant. In conclusion, pharmacist-led HMR programhas a positive impact on medication adherence, knowledge of antipsychotics, and quality of life on “social” and“family” components among people with schizophrenia.