A Comprehensive Pharmacist Intervention to Reduce Morbidity in Patients 80 Years or Older

Background  Patients 80 years or older are underrepresented in scientific studies. The objective of this study was to investigate the effectiveness of interventions performed by ward-based pharmacists in reducing morbidity and use of hospital care among older patients.

Conclusion  If implemented on a population basis, the addition of pharmacists to health care teams would lead to major reductions in morbidity and health care costs.
http://archinte.ama-assn.org/cgi/content/abstract/169/9/894?lookupType=volpage&vol=169&fp=894&view=short

Medication review and patient counselling at discharge from the hospital by community pharmacists

Aim  In 2001, the Association of Amsterdam Community Pharmacists adopted a programme to improve the pharmaceutical care of patients who were discharged from hospital with five or more drug prescriptions. A comprehensive protocol for pharmaceutical care at discharge (IBOM-1) was developed. The aim of the study was to evaluate the initial IBOM protocol and to study the effects of the protocol on drug therapy and patient satisfaction as well as on drug use compliance and mortality.

Conclusions Structured pharmaceutical care according to the IBOM-1 protocol led to more changes in drug therapy. Home visits resulted in the clearing of redundant home drug supplies. In addition, patients were highly satisfied with the counselling at discharge from hospital by their community pharmacist. Patient counselling at discharge from hospital by pharmacists, therefore, appears to be a meaningful pharmaceutical care activity.

http://www.springerlink.com/content/21062qth28427k45/?p=0a2ec3bf5198420395962e1f4a0bea29&pi=0

Development of an aggregated system for classifying causes of drug-related problems. Basger BJ, Moles RJ, Chen TF.  Ann Pharmacother 2015; 49 (4):405-418, 2015.
Background: More than 20 different types of classification systems for drug-related problems (DRPs) and their causes have been developed. Classification is necessary to describe and assess clinical, organizational, and economic impacts of DRPs through documentation of collected data. However, many researchers have judged classification systems incomplete when describing their data, and have modified them or developed their own. This variability between systems has made study comparisons difficult.

Objectives: To perform a category-by-category comparison of the content of selected DRP classification systems to construct an aggregated cause-of-DRP classification system containing the content of all systems.

Conclusion: An aggregated classification system was constructed through a unique and transparent developmental process that may provide the most comprehensive description of causes of DRPs to date. This may facilitate teaching of pharmaceutical care, comparisons of clinical practice, and measurement of the effectiveness of pharmaceutical care interventions.

http://aop.sagepub.com/content/49/4/405.long 

This poster ”From machine to mouth: How can automated dose dispensing lead to safer and more effective patient medication?” presents a research project on safety issues related to dose dispensing. It is a systematic  review of the literature and analysed Danish documentary data. Results from this study, together with results of a failure mode and effects analysis of automated dose dispensing in primary health care, may help guide the development of best practice guidelines for health care professionals with a focus on patient safety.

2011_03 Dosis_2delt_PCNE.pdf

Reports available in Danish;

• Dokumentanalyse af implementering og drift af dosisdispensering i kommuner og regioner. 2011. Download rapport
• Et litteraturstudie over erfaringer med brug af dosispakket medicin i Danmark. 2011. Download rapport
• Medicineringsfejl og utilsigtede hændelser ved dosispakket medicin. 2011. Download rapport

This poster ”Patient safety in the medication of disabled persons in residential facilities” presents an intervention study with the aim of increasing patient safety in the medication of physically or mentally disabled persons living in residential facilities through collaboration between pharmacies and residential facility staffs and during the quality assurance of medicine handling. Both services were able to identify patient safety and quality issues respectively, and to recommend interventions to remedy the identified issues.

2011_09_Handi_2delt_FIP.pdf

This poster ”Safe and Effective Use of Oral Antidiabetic Drugs: A Controlled Study of an Adherence-enhancing Intervention” presents evaluation of the effects, on patients outcomes, of a basic and an extensive concordance based intervention aimed to enhance medication adherence and self-management among type-2 diabetes patients in a Danish primary care setting. Both interventions were successfully implemented in a primary care setting and both showed clinical and patient-perceived effects on blood pressure, blood glucose, patient knowledge, adherence and HRQoL.

2008_09_FIP Safe and Effective Use of Oral Antidiabetic HH Poster.pdf

Report in Danish: 

• Sikker og effektiv medicinbrug for type-2 diabetikere - Færdigudvikling of evaluering af en regionalt forankret model, Version 1.1. - 2011, March 2011. Læs rapport
      

This poster ”Safe and effective use of antihypertensives. A controlled study of adherence-enhancing interventions” presents data on the implementation of a multidimensional patient-tailored counselling intervention to improve adherence and self-management among users of antihypertensive medication. The study concluded that a large variety of interventions were successfully, patient satisfaction results showed significant selfreported improvement for the intervention group when compared to the control group. Further, the effect study showed significant difference in adherence behaviour between the intervention and control groups.

2007_09_FIP Safe and effective use of antihypertensives.pdf  

Report available in Danish:

• Sikker og effktiv medicinbrug for brugere af blodtryksmedicin - Evaluering af implemetering og procesmål. Læs rapport

And an article:

• Development of new concepts of non-adherence measurements among users of antihypertensive medicines. Int J Clin Pharm (2011) 33:565-572. (Kjeldsen LJ, Bjerrum L, Herborg H, Knudsen P, Rossing R, Søndergaard B). Read abstract
   

This poster ”Better Use of Medicines - Use of clinical pharmacy to empower nursing homes towards safe medication practices” presents a study aiming developing and evaluating a clinical pharmacy-based model for nursing homes, supporting nursing home staff in providing quality in medicine administration and safe use of medicines for nursing home residents. It proved possible to use clinical pharmacy to empower nursing homes. Nursing home staff believed their competence and self efficacy increased towards providing better use of medicines for their residents.

2010_08 FIP_ISPWkonf BBM_2delt.pdf  

Report available in Danish:

• Bedre brug af medicin i hjemmepleje og på plejehjem. Et udviklings- og pilotprojekt for en kontrolleret undersøgelse. Evalueringsrapport. Rossing C, El-Souri M, Herborg H, Pultz K, Aagaard Thomsen L. Pharmakon 2010. Læs Evalueringsrapport. 
  Læs Resumé og Konklusioner
  
  

This poster "Identification of hypertensive patients at risk of non-adherence” presents the succesful development of a screening instrument for primary health care professionals in order to identify hypertensive patients at risk of non-adherent behaviour. The instrument may provide health care professionals in primary health care with a means to a focused dialogue with the hypertensive patients.

2009_09_FIP Identifi cation of hypertensive patients CR poster.pdf

Article available in Danish: 

• Identificering af nonkompliante patienter me dhypertension. Ugeskr læger 172/25. 21. juni 2010. (Agergaard M, Maibøll M, Dam P, Herborg H, Kreiner S, Rossing C & Sørensen L). Læs artikel