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%

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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