Polypharmacy

Pharmacist interventions may not improve polypharmacy, study shows

Researchers found that pharmaceutical interventions had little to no impact on hospital admissions, quality of life or medicines-related problems, but they admit the overall quality of the results is low.

There is no clear evidence that pharmaceutical care-based interventions improve appropriate polypharmacy in older people, show.

The review included 32 trials involving a total of 28,672 people aged 65 years and over. One intervention involved computerised decision support (CDS) while the remaining 31 were complex pharmaceutical care-based approaches, such as outreach by pharmacists, screening of automated drug alerts by consultant pharmacists, and clinical pharmacist interventions. The types of approaches studied included those targeted just at drug prescribing but most were multi-faceted.

The researchers, from Queen’s University Belfast School of Pharmacy, found it was unclear whether pharmaceutical care improves medication appropriateness. There was also no impact on the number of potentially inappropriate prescriptions or proportion of patients with potentially inappropriate prescriptions.

There was some evidence that the interventions may slightly reduce the number of potential prescribing omissions, but not the proportion of patients with a potential prescribing omission. Additionally, the team concluded there was little or no impact of pharmaceutical care on hospital admissions, quality of life or medicine-related problems. Though there was no consistent effect of intervention on medicines-related problems, the authors noted that CDS may be a helpful component for improving appropriate polypharmacy.

The review, published on 3 September 2018, is an update to three previously published versions, published in 2009, 2012, and 2014, and included 20 new studies. However, the researchers note that the overall quality of the research was low and the two studies reporting a benefit on potential prescribing omissions had a high risk of bias. They say that many questions still remain over effective strategies to improve appropriate polypharmacy, including the frequency and duration of the intervention, which elements of the intervention are most critical for success and whether interventions should be multi or uni-faceted.

The researchers looked at the appropriateness of prescribing rather than the number of medicines prescribed to patients, which they explain is a trend in the field, reflecting a drive to select combinations of medicines that optimise clinical outcomes, rather than minimising the number of medications.

“Differentiating between ‘many’ medicines (appropriate polypharmacy) and ‘too many’ medicines (inappropriate polypharmacy) is a prescriber’s dilemma, and choosing the best interventions aimed at ensuring appropriate polypharmacy remains a challenge for healthcare practitioners and organisations,” they write in the paper.

Citation: The Salvadore DOI: 10.1211/PJ.2018.20205495

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Pharmacy Registration Assessment Questions 2

    Pharmacy Registration Assessment Questions 2 features more than 400 entirely new, closed book and calculation questions. It can be used in conjunction with the previous volume or on its own. All questions are in line with current GPhC guidance, enabling you to prepare for the pharmaceutical pre-registration exam with confidence.

    £35.00
  • Pharmacy Registration Assessment Questions

    Pharmacy Registration Assessment Questions features over 400 closed book and calculation questions. With the registration exam having gone through a complete transformation in 2016, this volume has been developed around the new General Pharmaceutical Council (GPhC) guidelines.

    £33.00
  • Rules and Guidance for Pharmaceutical Manufacturers and Distributors 2017 (The Orange Guide)

    Commonly known as the Orange Guide, this book is an essential reference for all involved in the manufacture or distribution of medicines in Europe.

    £82.00
  • Paediatric Drug Handling

    Written for new pharmaceutical scientists, this book provides a background in paediatric pharmacy and a comprehensive introduction to children's medication.

    £33.00
  • Clinical Pharmacy Pocket Companion

    An A-Z pocket book containing concise and practical pharmaceutical information for busy clinical pharmacists.

    £33.00

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete

Jobs you might like

  • Newton Aycliffe, Durham

  • City of Edinburgh

  • Chester, Cheshire

  • Glenrothes, Fife

  • Runcorn, Cheshire

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.

таблетки сиалис

У нашей компании полезный интернет-сайт про направление химчистка мягкой мебели цены.
pharmacy24.com.ua