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Randomized Controlled Trial
The effects of a pharmacist-led medication review in a nursing home: A randomized controlled trial.
- Wen-Shyong Liou, Shih-Ming Huang, Wei-Hsin Lee, Yen-Lin Chang, and Ming-Fen Wu.
- Department of Pharmacy, Taichung Veterans General Hospital, Taichung, Taiwan, R.O.C.
- Medicine (Baltimore). 2021 Dec 3; 100 (48): e28023.
BackgroundIn this study, an intensive review of pharmaceutical care for elderly patients was conducted in a Veterans Administration nursing home in Taiwan and its effects were evaluated.MethodsOne hundred participants were enrolled in this randomized controlled study with even distribution. The inclusion criteria were age 65 years or older, prescriptions for at least 5 oral medicines daily, and ≥2 chronic diseases, for the period May 2013 to October 2014. Subjects were excluded if they had previously been included in an intensive medication review conducted by a pharmacist. The primary outcomes were numbers of drugs prescribed, potential inappropriate medications, and numbers of drug-related problems. The secondary outcomes were self-reported medical usages, measurements of quality of life, results of a satisfaction survey, and health status.ResultsA total of 80 cases (42 in the intervention group with medication reconciliation and 38 in the control group without medication reconciliation) completed the study. Baseline characteristics were not statistically different between the 2 groups. The overall prevalence of potential inappropriate medication was 74.3%. There were no differences between the 2 groups, with the exception of "medical problems," which showed a significantly higher prevalence in the intervention group (P < .05). The intervention group reported greater satisfaction regarding pharmacist visits and medication compliance (P < .01). The mean number of drug-related problems was significantly lower after the intervention (P < .01).ConclusionIn this study, the intensive review of the elderly patients' medications revealed that the only significant effect of pharmaceutical care was on "all outcomes." A possible reason for this is the rather advanced ages of some patients who needed a considerable number of medications to treat several chronic diseases. Another reason may be the small sample size. However, participants who received the pharmacist intervention did have higher satisfaction with medication reconciliation and fewer drug-related problems.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
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