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In-hospital medication reviews reduce unidentified drug-related problems

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Purpose

To examine the impact of a new model of care, in which a clinical pharmacist conducts structured medication reviews and a multi-professional team collates systematic medication care plans, on the number of unidentified DRPs in a hospital setting.

Methods

In a prospective two-period study, patients admitted to an internal medicine ward at the University Hospital of Lund, Sweden, were included if they were ≥ 65 years old, used ≥ 3 medications on a regular basis and had stayed on the ward for ≥ 5 weekdays. Intervention patients were given the new model of care and control patients received conventional care. DRPs were then retrospectively identified after study completion from blinded patient records for both intervention and control patients. Two pairs of evaluators independently evaluated and classified these DRPs as having been identified/unidentified during the hospital stay and according to type and clinical significance. The primary endpoint was the number of unidentified DRPs, and the secondary endpoints were the numbers of unidentified DRPs within each type and clinical significance category.

Results

The study included a total of 141 (70 intervention and 71 control) patients. The intervention group benefited from a reduction in the total number of unidentified DRPs per patient during the hospital stay: intervention group median 1 (1st–3rd quartile 0–2), control group 9 (6–13.5) (p < 0.001), and also in the number of medications associated with unidentified DRPs per patient: intervention group 1 (0–2), control group 8 (5–10) (p < 0.001). All sub-categories of DRPs that were frequent in the control group were significantly reduced in the intervention group. Similarly, the DRPs were less clinically significant in the intervention group.

Conclusions

A multi-professional team, including a clinical pharmacist, conducting structured medication reviews and collating systematic medication care plans proved very effective in reducing the number of unidentified DRPs for elderly in-patients.

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Authors and Affiliations

  1. The Department of Medicines Management and Informatics, Region Skåne, Kristianstad, Sweden

    Åsa Bondesson

  2. Department of Clinical Sciences, Lund University, Lund, Sweden

    Tommy Eriksson

  3. Department of Health Sciences, Division of Geriatric Medicine, Lund University, Malmö, Sweden

    Annika Kragh

  4. Department of Medicine, Skåne University Hospital, Malmö, Sweden

    Lydia Holmdahl

  5. Department of Clinical Sciences in Malmö, General Practice/Family Medicine, Lund University, Lund, Sweden

    Patrik Midlöv

  6. Department of Clinical Pharmacology, Lund University, Lund, Sweden

    Åsa Bondesson & Peter Höglund

Authors
  1. Åsa Bondesson
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  2. Tommy Eriksson
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  3. Annika Kragh
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  4. Lydia Holmdahl
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  5. Patrik Midlöv
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  6. Peter Höglund
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Correspondence to Åsa Bondesson.

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Bondesson, Å., Eriksson, T., Kragh, A. et al. In-hospital medication reviews reduce unidentified drug-related problems. Eur J Clin Pharmacol 69, 647–655 (2013). https://doi.org/10.1007/s00228-012-1368-5

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  • DOI: https://doi.org/10.1007/s00228-012-1368-5

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