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Are interventions recommended by pharmacists during Home Medicines Review evidence-based?


Castelino, RL and Bajorek, BV and Chen, TF, Are interventions recommended by pharmacists during Home Medicines Review evidence-based?, Journal of Evaluation in Clinical Practice, 17, (1) pp. 104-110. ISSN 1356-1294 (2011) [Refereed Article]

Copyright Statement

Copyright 2010 Blackwell

DOI: doi:10.1111/j.1365-2753.2010.01375.x


Abstract Introduction Over the past decade medication review services have been implemented in many countries, including Australia, UK and USA. Although, the attitudes and barriers to the implementation of evidence-based medicine have been investigated, the extent to which medication review recommendations are evidence-based is not known. Objective To determine (1) the extent to which pharmacist’s recommendations during medication review services were consistent with the evidence-based guides at the time of the review; and (2) the nature and extent of drug-related problems (DRPs) and the actions recommended by pharmacists to resolve DRPs. Method A retrospective review of Home Medicines Review cases performed on 224 community-dwelling older people (65 years or older). The chi-squared test for categorical variables was used to compare the proportion of recommendations that were evidencebased and recommendations for which no evidence could be identified in the most common Australian information sources. DRPs and the actions recommended to resolve the DRPs were classified according to previously employed criteria. Results Pharmacists made a total of 1114 therapeutic recommendations to general practitioners, of which 964 required supporting pharmacotherapeutic evidence. The majority (94%) of the pharmacists’ recommendations were in accordance with the evidence-based guides, as compared with the recommendations for which no evidence could be identified (P < 0.001). Pharmacists reported that 98% of the patients had at least one problem with use of their medication detected. Conclusion The majority of the actions recommended by pharmacists during the medication review process were consistent with the literature embedded in key Australian information sources. Medication management in older people is complex and challenging, as highlighted by the DRPs identified in 98% of our patients.Asuitably trained pharmacist, with full access to the patient, medical record and supporting resources, can help to improve the quality use of medicines in this at-risk population.

Item Details

Item Type:Refereed Article
Keywords:Evidence-based, drug-related problems, home medicines reviews
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Health
Objective Group:Other health
Objective Field:Other health not elsewhere classified
UTAS Author:Castelino, RL (Dr Ronald Castelino)
ID Code:86272
Year Published:2011 (online first 2010)
Web of Science® Times Cited:41
Deposited By:Pharmacy
Deposited On:2013-09-02
Last Modified:2017-12-13

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