Physicians’ acceptance of pharmaceutical medication
reviews in an institution for the Elderly
Buchmann S1, Krähenbühl J.M2, Nyffeler R3, Buchmann M1, Bugnon O2
1Tête-Noire Pharmacy, Romont, Switzerland; 2Universitary Medical Outpatient Clinic, Lausanne, Switzerland;
3Nursing Home of Billens, Switzerland
Objective and design
• Objective : Improve patient safety and drug efficiency in a nursing home, by developing a pharmaceutical medication review service
• Design :Prospective evaluation of physicians’ acceptance and of implementation of accepted interventions between February 2002 and January 2003
Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland
Design
Nursing home of Billens
6 physicians
77 patients
142 interventions
Accepted
Discussed
Refused
Refused
Accepted
Check of the degree of implementation 6 months after the review
Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland
Results
Repartition of the interventions
• 34% Interaction• 30% Inadequate treatment• 18% Proposal for a laboratory monitoring• 9% Adverse event• 5% Inadequate medicine’s strength• 4% Inadequate administration’s frequency
30% of the interventions were about the cardiovascular system and 23% were about the central nervous system
Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland
Results
Accepted pharmaceutical interventions
60% 58%
40%35% 31% 29%
0%
100%
Inte
ract
ion
Labo
rato
ry
Adm
inis
trat
ion'
sfr
eque
ncy
Trea
tmen
t
Adv
erse
eve
nt
Med
icin
e's
stre
ngth
Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland
Results
Clinical interest for physicians
Physicians' evaluation of the clinical interest of the 142 pharmaceutical interventions
6
48
74
14
Primordial
Very interesting
Theoretically interesting
Uninteresting
Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland
Results
Implementation 6 months after the review
• 22 accepted interventions concerning • Treatment• Medicine’s strength• Administration’s frequency
• 6 months after the review, check in the patients’ Kardex®
• 82 % of accepted interventions were effectively applied
Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland
Conclusions
This pharmaceutical medication review service
• Improved patients’ safety and drug efficiency
• Was frequently accepted and applied by physicians
• Enabled interdisciplinary work allowing an improvement in the quality of care
Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland
Future
Determine the pharmaco-economical
added value of the service
Evaluate the opportunity to disseminate it
to other institutions for the Elderly
Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland
Special thanks
For advices and support during this work: Dr med. B. Lanier, Nursing home of Billens, Switzerland Dr med. R. Brun, Nursing home of Billens, Switzerland Dr med. C. Huguenot, Nursing home of Billens, Switzerland Dr med. N. Gueissaz, Nursing home of Billens, Switzerland Dr med. J-L. Rime, Nursing home of Billens, Switzerland All the nurses of the Nursing home of Billens, Switzerland
For the realization of this presentation: M Ruggli, Swiss Pharmaceutical Society, Bern, Switzerland
Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland
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