Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-29T17:00:00.842Z Has data issue: false hasContentIssue false

Medication review for the older person

Published online by Cambridge University Press:  01 February 2007

Maggi Banning*
Affiliation:
Brunel University, School of Health Sciences and Social Care, Uxbridge, UK
*
Address for correspondence: M Banning, Brunel University, School of Health Sciences and Social Care, Mary Seacole Building, Uxbridge UB8 3PH, UK.

Extract

People of 65 years and older accounted for 21% of the population of England and Wales in 2001, and their proportion is increasing. It is forecast that the number of people over the age 75 years will double within the next 50 years, and that of those over the age of 90 will increase fivefold. The older patient with declining health poses significant challenges for health care professionals, in particular those of managing chronic morbidity and the effects of aging. Many older people require pharmacological treatment for multiple, co-existing pathologies. Those of 65 years and over receive 56% of all prescriptions in England, of which 78% are repeat prescriptions, and people in residential care, on average, receive five different medicines concurrently. The impact of repeat prescriptions means that, due to inadequate monitoring, many older people continue to administer medicines they no longer require, and thereby risk receiving an inappropriate drug, dose or duration of treatment. In addition to this, there is the propensity for older people to mismanage medicines, increasing their risk of unplanned drug-related admission to hospital and drug-related morbidity.

Type
Clinical geriatrics
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Refereces

1Office for National Statistics. Census data 2001 England and Wales. http://www.statistics.gov.uk/census2001/pyramids/printV/727.aspGoogle Scholar
2Osborne, C, Batty, G, Jackson, S. Prescription monitoring for elderly patients. Pharm J 1997; 259: 691–92.Google Scholar
3Roberston, RG, Montagnini, M. Geriatric failure to thrive. Am Fam Physician 2004; 70: 343–50.Google Scholar
4Department of Health. Prescriptions dispensed in the community statistics for 1992–2002; England. Prescription cost analysis. DOH. HMSO, London, 2002. http://www.publications.doh.uk/Public/sb0312.htmGoogle Scholar
5Williams, B, Nicol, M, Lowe, B, Yoon, P, McCombs, J, Margolies, J. Medication use in residential facilities for the elderly. Ann Pharmacother 1999; 33: 149–55.CrossRefGoogle ScholarPubMed
6McGovock, H, Wilson-Davies, K, Connolly, JP. Repeat prescribing management: a cause for concern? Br J Gen Pract 1999; 49: 343–47.Google Scholar
7Winterstein, AG, Sauer, BC, sHepler, CD, Poole, C. Implementing medicine-related aspects of the NSF for older people. DOH. HMSO, London, 2001.Google Scholar
8van Vliet, MJ, Grypdonck, MHF, Duijnstee, MSH. Improper intake of medication by elders–insights on contributing factors: a review of the literature. Res Theory Nurs Pract Intern J 2006; 20: 7993.CrossRefGoogle ScholarPubMed
9Medicines Partnership. Room for review. A guide to medication review: the agenda for patients, practitioners and managers. Medicines Partnership: London, 2002Google Scholar
10Howard, RL, Avery, AJ. Pharmacist-led medication reviews can reduce patient morbidity? Age Ageing 2006; 35: 555–56.CrossRefGoogle ScholarPubMed
11Department of Health. National Service Framework for Older People: implementing medicines-related aspects of the NDF for older people. DOH. HMSO, London, 2001.Google Scholar
12Krska, J, Ross, S. Medication review: whose job it is? Int J Pharm.Pract 2002; 10: 886.Google Scholar
13Lowe, CJ, Raynor, DK, Teale, C, Lubgan, G. Can practice nurses identify medication problems using the over-75 health check? J Clin Nurs 2000: 9: 816–17.CrossRefGoogle Scholar
14Fertleman, M, Barnett, N, Patel, T.Improving medication management for patients: the effect of a pharmacist on post-admission ward rounds. Qual Safety Health Care 2005; 14: 207–11.CrossRefGoogle Scholar
15Farris, KB, Ganther-Urmie, JM, Fang, G et al. Population-based medication reviews: a descriptive analysis of the medication issues identified in a Medicare not-for-profit prescription discount programme. Annals Pharm 2004: 38: 1823–29.Google Scholar
16Krska, J, Cromarty, JA, Arris, F et al. Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care. Age Ageing 2001; 30: 205–11.CrossRefGoogle ScholarPubMed
17Bellingham, C. Approaches to medication reviews. Do pharmacists, doctors and nurses take different approaches to medication reviews? Prescribing and Medicines' Management. Pharmaceut J 2005; 274: PM1.Google Scholar
18Petty, DR, Knapp, P, Raynor, DK, House, AO. Patients' views of a pharmacist-run medication review clinic in general practice. Br J Gen Pract 2003; 493: 607–13.Google Scholar
19Salterman, C, Holland, R, Harvey, I, Henwood, K. ‘I haven't even phoned my doctor yet’. The advice-giving role of the pharmacist during consultations for medication review with patients aged 80 or more: qualitative discourse analysis. BMJ; 334: 1101–10.CrossRefGoogle Scholar
20Holland, R, Lenaghan, E, Harvey, et al. Does home-based medication review keep older people out of hospital? The HOMER randomized controlled trial. BMJ 2005; 330: 293–95.CrossRefGoogle Scholar
21Mackie, CA, Lawson, DH, Maclaren, AG. A randomized controlled trial of medication review in patients receiving polypharmacy in general practice. Pharm J 1999; 263 (suppl):R7.Google Scholar
22Petty, DR, Zermansky Lowe, CJ, Raynor, DK. Pharmacist-conducted clinical medication-review clinic : consultation generator or saver? Pharm J 2000; 265: 29.Google Scholar
23Zermansky, AG, Petty, DR, Raynor, DK. Randomised controlled trial of clinical medication review by a pharmacist of elderly patients receiving repeat prescriptions in general practice. BMJ 2001; 323: 1340–44.CrossRefGoogle ScholarPubMed
24Zermansky, AG, Petty, DR, Raynor, DK. Clinical medication review by a pharmacist of patients on repeat prescriptions in general practice: a randomized controlled trial. Health Technol Assess 2002; 6: 186.CrossRefGoogle Scholar
25Zermansky, AG, Allred, DP, Petty, DR et al. Clinical medication review by a pharmacist of elderly people living in care homes– randomized controlled trial. Age Ageing 2006; 35: 586–91.CrossRefGoogle Scholar
26Holland, R, Brooks, I, Lengahan, E et al. Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomized controlled trial. BMJ 2007; 334: 1098–100.CrossRefGoogle Scholar
27Lenaghan, E, Holland, R, Brooks, A. Home-based medication review in a high-risk elderly population in primary care– the POLYMED randomized controlled trial. Age Ageing 2006; 36: 292–97.CrossRefGoogle Scholar
28Allard, J, Hebert, R, Rioux, M, Asselin, J, Voyer, L. Efficacy of a clinical medication review on the number of potentially inappropriate prescriptions prescribed for community-dwelling elderly people. CMAJ 2001; 164: 1291–96.Google ScholarPubMed
29Sellars, J, Kaczorowski, J, Sellors, C et al. . A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients. CMAJ 2003; 169: 915.Google Scholar
30Bernstein, C, Bjorkman, I, Caramona, M. Improving the well-being of elderly patients via community pharmacy-based provision of pharmaceutical care: a multicentre study in seven European countries. Drugs Ageing 2001; 18: 6377.CrossRefGoogle Scholar
31Lipton, HL, Bero, LA, Bird, JA. The impact of clinical pharmacists'consultations on physicians' geriatric drug prescribing. A randomized controlled trial. Med Care 1992; 30: 646–58.CrossRefGoogle ScholarPubMed
32Cody, M, McCombs, JS, Parker, JP. The Kaiser Permanente / USC patient consultation study: change in quality of life. University of Southern California. Am J Health Syst Pharm 1998; 55: 2615–20.CrossRefGoogle Scholar
33Malone, DC, Carter, BL, Billups, SJ. An economic analysis of a randomized, controlled multicenter study of clinical pharmacists' interventions for high–risk veterans: the IMPROVE Study. Impact of managed pharmaceutical care on resource utilization and outcomes in Veterans Affairs Medical Centers. Pharmacotherapy 2000; 20: 1149–58.CrossRefGoogle ScholarPubMed
34McMullin, ST, Hennefent, JA, Ritchie, DJ, Huey, WY, Lonergan, TP, Schiaff, RA. A prospective, randomized controlled trial to assess the cost impact of pharmacist-intiated interventions. Arch Intern Med 1999; 159: 2306–09.CrossRefGoogle ScholarPubMed
35Reeve, JF, Peterson, GM, Rumble, RH, Jaffrey, R. Programme to improve the use of drugs in older people and involve general practitioners in community education. J Clin Pharm Ther 1999; 24: 8997.CrossRefGoogle ScholarPubMed
36Sloane, PD, Zimmerman, S, Brown, LC, Ives, TJ, Walsh, JF. Inappropriate medication prescribing in residential care/assisted living facilites. J Am Geriatr Soc 2002; 50: 1001–11.CrossRefGoogle Scholar
37Ruths, S, Straand, J, Nyagaard, HA. Multidisciplinary medication review in nursing home residents: what are the most significant drug-related problems? The Bergen District Nursing Home (BEDNURS) Study. Qual Safety Health Care 2003; 12: 176–80.CrossRefGoogle ScholarPubMed
38Carlisle, S, Hudson, H. The general practitioner and older people strategies for more effective home visits. Health Soc Care Community 1997; 5: 365–74.CrossRefGoogle Scholar
39Turrell, A. Nursing homes: a suitable alternative to hospital care for older people in the UK? Age Ageing 2001; 30 (suppl 3)2432.CrossRefGoogle ScholarPubMed
40Furniss, L, Craig, SK, Burns, A. Medication use in nursing homes for elderly people. Int J Geriatr Psych. 1998; 13: 433–39.3.0.CO;2-9>CrossRefGoogle ScholarPubMed
41Royal, S, Smeaton, L, Avery, JA, Hurwitz, B, Sheikh, A. Interventions in primary care to reduce medication-related adverse events on hospital admissions: systematic review and meta-analysis. Qual Safety Health Care 2006; 15: 2331.CrossRefGoogle ScholarPubMed
42Healthcare Commission. The best medicine. The management of medicines in acute and specialist trusts. Acute Trust Portfolio Review. Commission for Health Care Audit and Inspection: London, 2007.Google Scholar
43Tulip, SC, Cheung, P, Campbell, D, Walters, P. Pharmaceutical care for older people: recording and review of medication following admission to hospital. Int J Pharm Pract 2002; 10 (suppl): R58.CrossRefGoogle Scholar
44Goodyer, L, Miskelly, F, Milligan, P. Does encouraging good compliance improve patients' clinical condition in heart failure? R J Clin Pract 1995; 49: 173–76.CrossRefGoogle ScholarPubMed
45Osborne, CA, Hooper, R, Swift, CG, Jackson, HD. Explicit, evidence-based criteria to assess the quality of prescribing to elderly nursing home residents. Age Ageing 2006; 32:102–08.CrossRefGoogle Scholar
46Banning, M. Medication review: the role of nurse-prescribers and community matrons. Nurs Prescribing 2006; 4: 198204.CrossRefGoogle Scholar
47Steel, S. Implications of medication reviews for postgraduate education and training. Pharm J 2005; 274: 758–59.Google Scholar
48Andalo, D. Medicines' management in English care homes– a grim and chaotic picture. Pharm J 2006; 274: 198–99.Google Scholar
49Frey, D. The Medication Management model: an effective tool for home health providers. Home Health Care Man Pract. 2003; 15: 222–30.CrossRefGoogle Scholar
50Crotty, M, Halert, J, Rowett, D et al. An outreach geriatric medication advisory service in residential aged care: a randomized controlled trial of case conferencing. Age Ageing 2004; 33: 612–17.CrossRefGoogle Scholar