Pharmacist Medication Review Reduces Unnecessary Prescriptions for Older Adults

A pharmacist-led medication review conducted for long-term care residents reduced unnecessary medications but did not impact outcomes related to falls and hospitalizations. Researchers published their findings in BMC Geriatrics.

“Residents in long-term care facilities often have multiple chronic disease states that increase their likelihood for polypharmacy and complex therapy regimens. This leads to an increased risk for drug-related problems in the [long-term care] setting for 75% of residents,” study authors said.

Researchers conducted a prospective, controlled intervention study at 3 long-term care facilities in Germany. Included residents were at least 65 years of age, taking at least 3 long-term/chronic medications, and had at least 3 comorbidities.

A one-time medication review was conducted by a pharmacist for each resident in the intervention group, while the control group received usual care. Pharmacists had access to residents’ medical records which included information about prescriptions, diagnoses, lab results, and measures like weight and blood pressure.

There were significantly more medication changes in the intervention group as compared to the control group, authors reported. Medication changes were more likely to be medication discontinuations than the addition of new drugs.

The most common prescribing problems were classified as ‘drug-drug interaction,’ ‘no clear indication for drug,’ and ‘insufficient drug treatment.’

“We assume that the intervention thereby contributes primarily to discontinuing unnecessary medication. However, no significant improvement was observed for hospital admissions, falls and deaths after the one-time intervention,” authors concluded.

Reference:
Lexow M, Wernecke K, Sultzer R, Bertsche T, Schiek S. Determine the impact of a structured pharmacist-led medication review – a controlled intervention study to optimise medication safety for residents in long-term care facilities. BMC Geriatr. 2022;22(1):307. doi:10.1186/s12877-022-03025-3