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Pharmacist-led medication reviews in primary care

Published online by Cambridge University Press:  02 December 2013

JA Desborough  and
MJ Twigg
JA Desborough*
Affiliation:
School of Pharmacy, University of East Anglia, Norwich, UK
MJ Twigg
Affiliation:
School of Pharmacy, University of East Anglia, Norwich, UK
*
Address for correspondence: Dr James Desborough, School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ. Email: j.desborough@uea.ac.uk
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Summary

Medication reviews in primary care are now an established and important part of the care of patients on multiple medications. In the current NHS this review has demonstrated that pharmacist-led medication reviews can reduce inappropriate prescribing and offer an efficient approach to ensuring reviews are completed. These reviews appear best operationalized with experienced pharmacists who are closely aligned with the patients and prescribers through joined up services. Further developments in pharmacists’ communication skills with patient and prescribers may offer greater benefits in the future.

Keywords

medication reviewprimary health careagedpharmacist
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 24 , Issue 1 , February 2014 , pp. 1 - 9
Copyright
Copyright © Cambridge University Press 2013 

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References

1Office of National Statistics. National Population Projections, 2010-based projections 2011 (accessed 4 September 2013). Available at: http://www.ons.gov.uk/ons/rel/npp/national-population-projections/2010-based-projections/index.htmlGoogle Scholar
2Mallet, L, Spinewine, A, Huang, A. The challenge of managing drug interactions in elderly people. Lancet 2007; 370: 185–91.CrossRefGoogle ScholarPubMed
3Rollason, V, Vogt, N. Reduction of polypharmacy in the elderly: a systematic review of the role of the pharmacist. Drugs Aging 2003; 20: 817–32.CrossRefGoogle ScholarPubMed
4The Information Centre. Prescriptions dispensed in the community. Statistics for 1996 to 2006: England. London: Government Statistical Service, 2007.Google Scholar
5Health & Social Care Information Centre. Prescriptions dispensed in the community: England 2002–2012. London: Government Statistical Service, 2013.Google Scholar
6Hajjar, ER, Cafiero, AC, Hanlon, JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother 2007; 5: 345–51.CrossRefGoogle ScholarPubMed
7Campbell, SE, Seymour, DG, Primrose, WR. A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age Ageing 2004; 33: 110–15.CrossRefGoogle ScholarPubMed
8Frazier SC. Health outcomes and polypharmacy in elderly individuals: an integrated literature review. J Gerontol Nurs 2005; 31: 4–11.CrossRefGoogle Scholar
9Howard, RL, Avery, AJ. Pharmacist-led medication reviews can reduce patient morbidity? Age Ageing 2006; 35: 555–56.CrossRefGoogle ScholarPubMed
10Pirmohamed, M, James, S, Meakin, S, Green, C, Scott, AK, Walley, TJet al.Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients. BMJ 2004; 329: 15–19.CrossRefGoogle Scholar
11Department of Health. National Service Framework for Older People. London: The Stationery Office, 2001.Google Scholar
12Department of Health. National Service Framework for long term conditions. London: The Stationery Office, 2005.Google Scholar
13British Medical Association. Revisions to the GMS contract 2006/7: Delivering investment in general practice. London: BMA, 2006.Google Scholar
14Pharmaceutical Services Negotiating Committee. The new contract for community pharmacy. Aylesbury: PSNC; 2004.Google Scholar
15Clyne, W, Blenkinsopp, A, Seal, R. A guide to medication review. Liverpool: National Prescribing Centre, 2008.Google Scholar
16Royal, S, Smeaton, L, Avery, AJ, Hurwitz, B, Sheikh, A. Interventions in primary care to reduce medication related adverse events and hospital admissions: systematic review and meta-analysis. Qual Saf Health Care 2006; 15: 23–31.CrossRefGoogle ScholarPubMed
17Petty, DR, Zermansky, AG, Raynor, DK. Evidence shows medication reviews by pharmacists point way forward. Pharm J 2001; 267: 863–64.Google Scholar
18Krska, J, Cromarty, JA, Arris, F, Jamieson, D, Hansford, D, Duffus, PRSet al.Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care. Age Ageing 2001; 30: 205–11.CrossRefGoogle ScholarPubMed
19Lau, E, Dolovich, LR. Drug-related problems in elderly general practice patients receiving pharmaceutical care. Int J Pharm Practice 2005; 13: 165–77.CrossRefGoogle Scholar
20Holland, R, Desborough, J, Goodyer, L, Hall, S, Wright, D, Loke, YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. Br J Clin Pharmacol 2008; 65: 303–16.CrossRefGoogle ScholarPubMed
21Department of Health. Equity and Excellence: liberating the NHS. London: The Stationery Office; 2010.Google Scholar
22Mackie, C, Lawson, D, Campbell, A, Maclaren, A, Waigh, R. A Randomised controlled trial of medication review in patients receiving polypharmacy in general practice. Pharm J 1999; 263: R7.Google Scholar
23Zermansky, AG, Petty, DR, Raynor, DK, Freemantle, N, Vail, A, Lowe, CJ. Randomised controlled trial of clinical medication review by a pharmacist of elderly patients receiving repeat prescriptions in general practice. BMJ 2001; 323: 1340–43.CrossRefGoogle ScholarPubMed
24Holland, R, Lenaghan, E, Harvey, I, Smith, R, Shepstone, L, Lipp, Aet al.Does home based medication review keep older people out of hospital? The HOMER randomised controlled trial. BMJ 2005; 330: 293–97.CrossRefGoogle ScholarPubMed
25Holland, R, Brooksby, I, Lenaghan, E, Ashton, K, Hay, L, Smith, Ret al.Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial. BMJ 2007; 334: 1098.CrossRefGoogle ScholarPubMed
26Lenaghan, E, Holland, R, Brooks, A. Home-based medication review in a high risk elderly population in primary care – the POLYMED randomised controlled trial. Age Ageing 2007; 36: 292–97.CrossRefGoogle Scholar
27Hay, EM, Foster, NE, Thomas, E, Peat, G, Phelan, M, Yates, HEet al.Effectiveness of community physiotherapy and enhanced pharmacy review for knee pain in people aged over 55 presenting to primary care: pragmatic randomised trial. BMJ 2006; 333: 995–98.CrossRefGoogle ScholarPubMed
28Laucka, PV, Webster, WB, Kuch, J. Pharmacist review to simplify medication regimens in a VAMC primary care clinic. J Pharm Tech 1996; 12: 62–66.CrossRefGoogle Scholar
29Leikola, SN, Virolainen, J, Tuomainen, L, Tuominen, RK, Airaksinen, MS. Comprehensive medication reviews for elderly patients: findings and recommendations to physicians. J Am Pharm Assoc 2012; 52: 630–33.CrossRefGoogle ScholarPubMed
30Milos, V, Rekman, E, Bondesson, A, Eriksson, T, Jakobsson, U, Westerlund, Tet al.Improving the quality of pharmacotherapy in elderly primary care patients through medication reviews: a randomised controlled study. Drugs Aging 2013; 30: 235–46.CrossRefGoogle ScholarPubMed
31Sellors, J, Kaczorowski, J, Sellors, C, Dolovich, L, Woodward, C, Willan, Aet al.A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients. CMAJ 2003; 169: 17–22.Google ScholarPubMed
32de Lyra, DP Jr, Kheir, N, Abriata, JP, da Rocha, CE, dos Santos, CB, Pela, IR. Impact of pharmaceutical care interventions in the identification and resolution of drug-related problems and on quality of life in a group of elderly outpatients in Ribeirao Preto (SP), Brazil. Therap Clin Risk Management 2007; 3: 989–98.Google Scholar
33Furniss, L, Burns, A, Craig, SKL, Scobie, S, Cooke, J, Faragher, B. Effects of a pharmacist's medication review in nursing homes: randomised controlled trial. Br J Psychiatry 2000; 176: 563–67.CrossRefGoogle ScholarPubMed
34Roberts, MS, Stokes, JA, King, MA, Lynne, TA, Purdie, DM, Glasziou, PPet al.Outcomes of a randomized controlled trial of a clinical pharmacy intervention in 52 nursing homes. Br J Clin Pharmacol 2001; 51: 257–65.CrossRefGoogle ScholarPubMed
35Zermansky, AG, Alldred, DP, Petty, DR, Raynor, DK, Freemantle, N, Eastaugh, Jet al.Clinical medication review by a pharmacist of elderly people living in care homes – randomised controlled trial. Age Ageing 2006; 35: 586–91.CrossRefGoogle ScholarPubMed
36Maack, B, Miller, DR, Johnson, T, Dewey, M. Economic impact of a pharmacy resident in an assisted living facility-based medication therapy management program. Annals Pharmacotherapy 2008; 42: 1613–20.CrossRefGoogle Scholar
37Kersten, H, Molden, E, Tolo, IK, Skovlund, E, Engedal, K, Wyller, TB. Cognitive effects of reducing anticholinergic drug burden in a frail elderly population: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 2013; 68: 271–78.CrossRefGoogle Scholar
38Nishtala, PS, McLachlan, AJ, Bell, JS, Chen, TF. A retrospective study of drug-related problems in Australian aged care homes: medication reviews involving pharmacists and general practitioners. J Evaluation Clin Practice 2011; 17: 97–103.CrossRefGoogle ScholarPubMed
39Celino, G, Levenson, R, Dhalla, M. Evaluation of Room for Review – a guide to medication review. Part 1 – the PCT and professional view. Medicines Partnership, 2005.Google Scholar
40Colquhoun, A. Asking the right questions in Parkinson's. Pharm J 2010; 285: 626.Google Scholar
41Colquhoun, A. Home MURs help free hospital beds. Pharm J 2010; 285: 615.Google Scholar
42Portlock, J, Holden, M, Patel, S. A community pharmacy asthma MUR project in Hampshire and the Isle of Wight. Pharm J 2009; 282: 109–12.Google Scholar
43The Cambridge Consortium. Evaluation of the Inhaler Improvement Project 2012 (accessed 24 November 2012). Available at: http://www.networks.nhs.uk/nhs-networks/south-east-coast-respiratory-programme/documents/120904%20CIREM_ITIP_HIEC_Evaluation.pdfGoogle Scholar
44Ali, M, Malik, M, Kugarajah, T, Phillips, G. Evaluation of Medicines Use Review (MUR) service in a community pharmacy group. Int J Pharmacy Practice 2011; 19 (suppl 2): 38–64.Google Scholar
45Youssef, S, Hussain, S, Upton, D. Do patients perceive any benefit from medicines use reviews offered to them in community pharmacies? Pharm J 2010; 284: 165–66.Google Scholar
46Cree, N. Depressed patients can gain from directed MURs. Pharm J 2010 285: 581.Google Scholar
47Richardson, E, Pollock, AM. Community pharmacy: moving from dispensing to diagnosis and treatment. BMJ 2010; 340: 1066–68.CrossRefGoogle ScholarPubMed
48Bryant, L, Coster, G, Gamble, G, McCormick, R. General practitioners’ and pharmacists’ perceptions fo the role of community pharmacists in delivering clinical services. Res Soc Adm Pharm 2009; 5: 347–62.CrossRefGoogle Scholar
49Wilcock, M, Harding, G. General practitioners’ perceptions of medicines use reviews by pharmacists. Pharm J 2007; 279: 501–3.Google Scholar
50Department of Health. A vision for pharmacy in the new NHS. London: The Stationery Office; 2003.Google Scholar
51Department of Health. Choosing health through pharmacy – a programme for pharmaceutical public health 2005–2015. London: The Stationery Office; 2005.Google Scholar
52Department of Health. Pharmacy in England: building on strengths – delivering the future. London: The Stationery Office; 2008.Google Scholar
53The Community Pharmacy Medicines Management Project Evaluation Team. The MEDMAN study: a randomized controlled trial of community pharmacy-led medicines management for patients with coronary heart disease. Family Practice 2007; 24: 189–200.CrossRefGoogle Scholar
54Richmond, S, Morton, V, Cross, B, Chi Kei Wong, I, Russell, I, Philips, Zet al.Effectiveness of shared pharmaceutical care for older patients: RESPECT trial findings. Br J General Practice 2010; 60: 14–20.Google Scholar
55Bojke, CP, Philips, Z, Sculpher, M, Campion, P, Chrystyn, H, Coulton, S, Cross, B, Morton, V, Richmond, S, Farrin, A, Hill, G, Hilton, A, Miles, J, Russell, I, Wong, I. Cost-effectiveness of shared pharmaceutical care for older patients: RESPECT trial findings. Br J Gen Pract 2010; 60: e20–27.Google Scholar
56Bryant, LJM, Coster, G, Gamble, GD, McCormick, RN. The General Practitioner–Pharmacist Collaboration (GPPC) study: a randomised controlled trial of clinical medication reviews in community pharmacy. Int J Pharmacy Practice 2011; 19: 94–105.CrossRefGoogle ScholarPubMed
57Denneboom, W, Dautzenberg, MGH, Grol, R, De Smet, PAGM. Treatment reviews of older people on polypharmacy in primary care: cluster controlled trial comparing two approaches. Br J General Practice 2007; 57: 723–31.Google ScholarPubMed
58Desborough, J, Houghton, J, Wood, J, Wright, D, Holland, R, Sach, Tet al.Multi-professional clinical medication reviews in care homes for the elderly: study protocol for a randomised controlled trial with cost effectiveness analysis. Trials 2011; 12: 218.CrossRefGoogle ScholarPubMed
59Holland, R, Lenaghan, E, Harvey, I, Smith, R, Shepstone, L, Lipp, Aet al.Does home based medication review keep older people out of hospital? The HOMER randomised controlled trial. BMJ 2005; 330: 293.CrossRefGoogle ScholarPubMed
60Salter, 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 2007; 334: 1101.CrossRefGoogle ScholarPubMed
61Latif, A, Pollock, K, Boardman, HF. The contribution of the Medicines Use Review (MUR) consultation to counselling practice in community pharmacies. Patient Education Counselling 2011; 83: 336–44.CrossRefGoogle ScholarPubMed