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Impact of medication reviews on inappropriate prescribing in aged care


Koria, LG and Zaidi, TS and Peterson, G and Nishtala, P and Hannah, PJ and Castelino, R, Impact of medication reviews on inappropriate prescribing in aged care, Current Medical Research and Opinion, 34, (5) pp. 833-838. ISSN 0300-7995 (2018) [Refereed Article]


Copyright Statement

Copyright 2018 Informa UK Limited, trading as Taylor & Francis Group

DOI: doi:10.1080/03007995.2018.1424624


Background: Inappropriate prescribing (IP) is prevalent among elderly people in aged care facilities. Little has been published on the effect of pharmacists performing residential medication management reviews (RMMRs) in aged care on the appropriateness of prescribing. RMMRs represents a key strategy for achieving quality use of medicines, by assisting residents in aged care facilities and their carers to better manage their medicines. However, the structure of RMMR has moved from annual to every two years for each resident.

Objectives: The primary objective of this study was to investigate the impact of pharmacists performing RMMRs on medication use appropriateness, as measured by the Medication Appropriateness Index (MAI).

Methods: Retrospective analysis of RMMRs pertaining to 223 aged care residents aged ≥65 years in Sydney, Australia. The MAI was applied on two RMMR cohorts; newer cohort (n = 111, 2015) i.e. following the recent changes to the RMMR funding and older cohort (n = 112, 2012) at baseline, after pharmacists' recommendations (assuming all pharmacists' recommendations were accepted by the General Practitioner [GP]), and after the actual uptake of pharmacists' recommendations by the GP. Differences in inappropriate prescribing were measured using the Wilcoxon sign rank test.

Results: Overall, all patients in the study (n = 223) had at least one inappropriate rating at baseline (median MAI score of 26 for the old cohort and 27 for the newer cohort). The median cumulative MAI scores were significantly lower after the RMMRs by pharmacists (15.5 and 20 for the old and new cohort respectively, p < .001) and following the uptake of recommendations by the GP, indicating an increased appropriateness of drug regimen after the medication review (20 and 22 for the old and new cohort respectively, p < .001).

Conclusion: This study shows that pharmacist-led medication reviews are effective in reducing inappropriate prescribing among aged care residents, as demonstrated by the reduction in MAI scores. Future studies should focus on the impact of such a decrease on patient outcomes.

Item Details

Item Type:Refereed Article
Keywords:inappropriate prescribing, medication reviews, Medication Appropriateness Index, older people, elderly, aged care, pharmacists
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health and support services not elsewhere classified
UTAS Author:Zaidi, TS (Dr Tabish Razi Zaidi)
UTAS Author:Peterson, G (Professor Gregory Peterson)
UTAS Author:Castelino, R (Dr Ronald Castelino)
ID Code:123413
Year Published:2018
Web of Science® Times Cited:10
Deposited By:Pharmacy
Deposited On:2018-01-05
Last Modified:2019-01-29
Downloads:21 View Download Statistics

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