gms | German Medical Science

23rd Annual Meeting of the German Drug Utilisation Research Group (GAA)

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

24.11. - 25.11.2016, Bochum

Development and evaluation of an algorithm in Medication Management for best practice. Effectiveness of the intervention and translation into standard care for nursing home residents – AMBER-Study, study design

Meeting Abstract

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Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 23. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Bochum, 24.-25.11.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16gaa16

doi: 10.3205/16gaa16, urn:nbn:de:0183-16gaa163

Published: November 23, 2016

© 2016 Erzkamp et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Background: Medication Therapy Management is an international well established tool of pharmaceutical care to increase therapy quality [1], [2], [3]. In Germany this service is not part of current standard care and is not established in everyday practice.

Residents of nursing home facilities are a vulnerable patient group for medication risk [4], [5]. Old age, need for care, multimorbitiy and polymedication are common risk factors [6], [7]. Fall hazard, hospitalization and numerous general practitioner contacts can be linked to inappropriate medication [8], [9], [10]. To support pharmacists in performing a structured Medication Review and to find and solve frequent and relevant problems in an appropriate timeframe, an algorithm is developed and evaluated.

Materials and Methods: In study phase I interviews with patients, physicians, pharmacists and nurses in North Rhine-Westphalia are performed with the aim of addressing relevant medication problems. In phase II an algorithm for Medication Reviews is developed based on the qualitative results of phase I, and considering the outcomes of international studies. The algorithm is applied and tested for practicability and effectiveness in phase III in an open, single arm, interventional study. The following inclusion criteria are defined: patients age ≥65 years, residency in a nursing home facility, multimorbidity (at least 2 chronic diseases), polymedication (at least 5 chronic systemic available medications) and signed informed consent. Participation in other clinical studies at present time is an exclusion criterion.

Several patient cases are reviewed by clinical experts and by community pharmacists using the algorithm. Translation into daily practice and feasibility are assessed by comparing the obtained drug-related problems.

The primary and secondary endpoints will be defined according to the results of study phase I. Drug-related problems and acceptance of the suggestions by general practitioners and nurses are evaluated.

Results: Results are not yet obtained.

Conclusion: It is expected that the algorithm detects relevant drug related problems, reduces medication risks and optimizes drug therapy. The algorithm is designed to support the pharmacist with a structured approach on relevant aspects translated to nursing-home patient care, considering limited time in daily practice.

A research grant was provided by the noncommercial foundation "Apothekerstiftung Westfalen-Lippe".


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