A shared medication scheme for community dwelling older patients with polypharmacy receiving home health care: role of the community pharmacist

Background and objective: An accurate medication scheme may be a useful tool to improve medication safety in primary care. This study aimed to identify (1) pharmacists' alterations to nurse medication schemes and (2) potential improvements to the contribution of the community pharmacist to a sh...

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Bibliographic Details
Published in:Acta clinica belgica (English ed. Online) 2019-10, Vol.74 (5), p.326-333
Main Authors: Foubert, Katrien, Mehuys, Els, Claes, Leen, Van Den Abeele, Dirk, Haems, Marleen, Somers, Annemie, Petrovic, Mirko, Boussery, Koen
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Clinical Protocols
Collaboration
community dwelling
Community Pharmacy Services - organization & administration
Cross-Sectional Studies
Delivery of Health Care - methods
Delivery of Health Care - organization & administration
Drug dosages
Female
Home health care
Home Health Nursing - organization & administration
Humans
Independent Living
Male
medication complexity
Medication safety
medication scheme
Patient Care Team
pharmacist
Pharmacists
Polypharmacy
Professional Role
Researchers
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Summary:Background and objective: An accurate medication scheme may be a useful tool to improve medication safety in primary care. This study aimed to identify (1) pharmacists' alterations to nurse medication schemes and (2) potential improvements to the contribution of the community pharmacist to a shared medication scheme within a multidisciplinary collaboration. Dosing frequency, potentially incorrect moments of intake, drug-drug interactions and medication complexity (quantified by the Medication Regimen Complexity Index, MRCI) were investigated. Setting and method: Observational study in community dwelling older patients (≥70 years) with polypharmacy receiving home health care (i.e. medications being prepared and/or administered by home care nurses). Home care nurses provided the community pharmacist with the original medication scheme ('nurse medication scheme'), subsequently the community pharmacist generated a standardized 'pharmacist medication scheme' which was uploaded on an electronic health platform (Vitalink). The researcher recorded all pharmacists' alterations and looked for possible additional improvements ('researcher medication scheme'). Results: Pharmacists made 482 alterations to the nurse medication schemes of 31 patients. Most important alterations included adding indication (61%), generic or brand name (18%) and moment of intake (9%). Pharmacists did not reduce dosing frequency. MRCI scores (median [IQR]) significantly differed between pharmacist (38 [15]) and nurse medication schemes (32 [11]) (p 
ISSN:1784-3286
2295-3337
DOI:10.1080/17843286.2018.1521903