Interventies na een gestructureerde medicatie-analyse door klinisch geriater en ziekenhuisapotheker bij klinisch opgenomen kwetsbare oudere patiënten
- 1 April 2009
- journal article
- Published by Radboud University in Tijdschrift voor Gerontologie en Geriatrie
- Vol. 40 (2), 35-41
- https://doi.org/10.1007/bf03079563
Abstract
Door middel van een gestructureerde medicatie-analyse door klinisch geriater en ziekenhuisapotheker-klinisch farmacoloog zijn (potentiële) geneesmiddelgerelateerde problemen in kaart gebracht. Patiënten die werden opgenomen op de afdeling geriatrie en waar de klinisch geriater en/of de ziekenhuisapotheker problemen zagen of voorzagen werden beoordeeld volgens een vast model. De voorgestelde interventies werden plenair besproken en de uitgevoerde (of overgenomen) interventies werden vervolgd. In een periode van 30 maanden werden de medicatiegegevens van 184 patiënten aan een medicatie-analyse onderworpen. Van de voorgestelde interventies door de ziekenhuisapotheker werd 65% overgenomen door de klinisch geriater. Het stoppen van medicatie, doseerwijzigingen of vervangen van een bestaand middel werden het meest uitgevoerd. Interventievoorstellen die niet werden overgenomen betroffen vooral onwil van de patiënt of diens begeleider of logistieke problemen. Objective To study the results of a structured medication review of geriatric inpatients by both geriatrician and hospital pharmacist/clinical pharmacologist. Methods Patients who were present at the geriatric ward were eligible for a review of their medication and medical problems using a screening form. Recommendations and questions following these forms were subsequently discussed in the gerontopharmacologic meeting (‘GFO’) held every two weeks. Results In a 30 month-period 44 GFO’s were held during which 184 patients were discussed. A total of 206 recommendations were made and 115 questions were asked. Of the recommended interventions,134 (65%) were accepted by the geriatrician. To stop a medication (64/206), to change the dosage of a medication (60/206) and to switch to another medication (44/206) were the types of interventions most accounted for. Conclusion Structured medication review led to a substantial number of medication changes in geriatric inpatients. Nearly two-thirds of the recommended interventions were accepted by the geriatricians. Seventy-two recommendations (35%) were not implemented due to logistic or patient-related reasons.Keywords
This publication has 20 references indexed in Scilit:
- Quality Indicators for Medication Use in Vulnerable EldersJournal of the American Geriatrics Society, 2007
- Appropriate prescribing in elderly people: how well can it be measured and optimised?The Lancet, 2007
- Inappropriate prescribing in the elderlyJournal of Clinical Pharmacy & Therapeutics, 2007
- A Composite Screening Tool for Medication Reviews of OutpatientsDrugs & Aging, 2007
- Clinical Pharmacists and Inpatient Medical CareArchives of Internal Medicine, 2006
- Does home based medication review keep older people out of hospital? The HOMER randomised controlled trialBMJ, 2005
- Hospitalization and Death Associated With Potentially Inappropriate Medication Prescriptions Among Elderly Nursing Home ResidentsArchives of Internal Medicine, 2005
- The Association of Inappropriate Drug Use with Hospitalisation and MortalityDrugs & Aging, 2005
- Medication-Related Problems in the ElderlyDrugs & Aging, 2005
- A method for assessing drug therapy appropriatenessJournal of Clinical Epidemiology, 1992