Article
Potentials to optimize the pharmacotherapy of geriatric residents in nursing homes by pharmaceutical care
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Authors
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J. Kruse
- Institut für Pharmazeutische und Medizinische Chemie, Klinische Pharmazie, Westfälische Wilhelms-Universität Münster, Germany
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I. Waltering
- Landesinstitut für Gesundheit und Arbeit des Landes Nordrhein-Westfalen, Düsseldorf, Germany
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U. Puteanus
- Landesinstitut für Gesundheit und Arbeit des Landes Nordrhein-Westfalen, Düsseldorf, Germany
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G. Hempel
- Institut für Pharmazeutische und Medizinische Chemie, Klinische Pharmazie, Westfälische Wilhelms-Universität Münster, Germany
| Published: | November 5, 2009 |
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Outline
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Background and aim: During the last years pharmaceutical care has become more important to optimize pharmacotherapy. Especially geriatric patients due to polypharmacy and age-related changes in metabolism are at an increased risk for drug-drug-interactions, drug-disease-interactions and unwanted side-effects.
The aim of the project is to reduce medication associated problems of nursing home residents, improve their quality of life and reduce health care costs by lowering the number of hospital admissions or other effects.
Material and method: In 16 nursing homes from four different counties approximately 550 residents were recruited and complete patient data were affiliated over a period of six months. Inclusion criteria were: age=65 years, =3 medications and no progressive course of illness. Residents gave their informed consent to this appraisal.
To evaluate the basal health state of the residents a questionnaire based on the “Aktivitäten und existenzielle Erfahrungen des Lebens” (AEDL) of Krohwinkel was developed and conducted by nursing staff.
The following 18 months medication reviews are conducted and assessed with the Medication appropriateness index (MAI) of Hanlon JT et al. 1992 as well with START- and STOPP-criteria (Gallager P et al. 2007, Barry PJ et al. 2008). Interactions are checked with the ABDA-Database and potential drug-related problems are classified. Improvement of pharmacotherapy should be achieved by discussing medication-related problems with an interdisciplinary team including practitioner, nursing staff and pharmacist. Further on nursing staff should be teached on special aspects of applying drugs. Based on the experience community pharmacies should be trained to offer this service regularly.
Results: At the time of the abstract-deadline the project is standing at the end of the first 6-month period. Only limited data are available so further work-up needs to be done to present results.
Conclusions: With medication management, improved communication between practitioner and pharmacist and cooperation with the pharmacies an optimized pharmacotherapy of the geriatric residents should be achieved. Especially the importance of pharmaceutical care conducted by pharmacists to secure medication therapy should be emphasized.
