TY - JOUR
T1 - Effect of pharmacist-led medication review on medication appropriateness in older adults with chronic kidney disease
AU - Tesfaye, Wubshet H.
AU - Wimmer, Barbara C.
AU - Peterson, Gregory M.
AU - Castelino, Ronald L.
AU - Jose, Matthew
AU - McKercher, Charlotte
AU - Zaidi, Syed Tabish R.
PY - 2019/10
Y1 - 2019/10
N2 - This study evaluated the effect of pharmacist-led review on medication appropriateness in 204 older patients with chronic kidney disease (CKD) admitted to an Australian hospital. Medication appropriateness was evaluated using the Medication Appropriateness Index (MAI) prior to medication review, after review (assuming all recommendations were accepted by physicians) and after outcome (acceptance/non-acceptance) of recommendations. Overall, 95 patients (46%) received a medication review by pharmacists. The median (interquartile range) MAI score decreased significantly from a baseline of 7 (3–12) to 5 (2–10) after medication review (p < 0.001) and to 6 (2–10) after the outcome of recommendations (p < 0.01). The MAI score also decreased in patients with no medication review by a pharmacist from 6 (3–11) at admission to 5 (2–9) at discharge (p < 0.001). MAI scores declined markedly in people with all pharmacist-conducted medication review recommendations accepted (from 7 to 3; p < 0.05). Reassuringly, hospitalisation alone improved medication appropriateness. However, pharmacist-led medication review can further optimise medication appropriateness in older CKD patients, particularly when the recommendations are implemented.
AB - This study evaluated the effect of pharmacist-led review on medication appropriateness in 204 older patients with chronic kidney disease (CKD) admitted to an Australian hospital. Medication appropriateness was evaluated using the Medication Appropriateness Index (MAI) prior to medication review, after review (assuming all recommendations were accepted by physicians) and after outcome (acceptance/non-acceptance) of recommendations. Overall, 95 patients (46%) received a medication review by pharmacists. The median (interquartile range) MAI score decreased significantly from a baseline of 7 (3–12) to 5 (2–10) after medication review (p < 0.001) and to 6 (2–10) after the outcome of recommendations (p < 0.01). The MAI score also decreased in patients with no medication review by a pharmacist from 6 (3–11) at admission to 5 (2–9) at discharge (p < 0.001). MAI scores declined markedly in people with all pharmacist-conducted medication review recommendations accepted (from 7 to 3; p < 0.05). Reassuringly, hospitalisation alone improved medication appropriateness. However, pharmacist-led medication review can further optimise medication appropriateness in older CKD patients, particularly when the recommendations are implemented.
KW - chronic kidney disease
KW - Medication Appropriateness Index
KW - potentially inappropriate medications
UR - http://www.scopus.com/inward/record.url?scp=85073605027&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/d32c9d21-61e6-3d47-8c19-17d9393306a5/
U2 - 10.1002/jppr.1539
DO - 10.1002/jppr.1539
M3 - Review article
AN - SCOPUS:85073605027
SN - 1445-937X
VL - 49
SP - 471
EP - 476
JO - Journal of Pharmacy Practice and Research
JF - Journal of Pharmacy Practice and Research
IS - 5
ER -