Pharmacist-led medication review in elderly patients in Flanders: a pilot study
De Wulf, Isabelle Depuydt, Charlotte Develter, Marlies De Waele, Lies Leyssens, Anneleen Pierreux, Tina Vansteenkiste, Dafne Vermaelen, Karen Vermeir, Sofie Foulon, Veerle #
PCNE Working conference edition:7 location:Manchester date:23-26 March 2011
Aim of project/study
Medication review is one of the procedures that can be used to minimize the risk for drug related problems in the elderly. The aim of this study was to research the feasibility of pharmacist-led medication review in the Flanders and to check the usability of procedures and instruments developed for this purpose.
In a first step of the project, a procedure for a comprehensive medication review was developed, and instruments selected from the literature (Brief Medication Questionnaire, START and STOPP criteria) were translated and adapted for use in Belgium. Secondly, pharmacists from all over Flanders were asked to freely enrol for a pilot program, and to perform five medication reviews for patients aged > 65 and taking five or more drugs. The results of these medication reviews were analysed. Experiences of pharmacists, physicians and patients were questioned using written surveys.
32 pharmacists enrolled for the pilot program. Following regional training sessions, 11 pharmacists performed one or more medication reviews; in total 30 reviews were performed. Using the START and STOPP criteria, problems were detected in 42% and 71% of cases respectively. These criteria were considered useful, but incomplete to cover all drug related problems. The adapted version of the BMQ was well accepted and quick in use. Information leaflets for physicians, pharmacists and patients were considered adequate. Physicians, pharmacists and patients evaluated the medication review as useful. The most important reasons for pharmacists not performing reviews were lack of time and difficult communication with the GP.
Given the fact that many pharmacists dropped out after the training sessions, there is still a way to go for the implementation of medication review in daily practice in Flanders.