Premium
Improving medication safety for home nursing clients: A prospective observational study of a novel clinical pharmacy service—The Visiting Pharmacist (ViP) study
Author(s) -
Lee C. Y.,
Beanland C.,
Goeman D.,
Petrie N.,
Petrie B.,
Vise F.,
Gray J.,
Elliott R. A.
Publication year - 2018
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12712
Subject(s) - observational study , pharmacist , pharmacy , nursing , medicine , clinical pharmacy , service (business) , family medicine , business , marketing
Summary What is known and objective Polypharmacy, medication errors and adverse events are common in older people receiving home nursing medication management support. Access to clinical pharmacists is limited. In Australia, few home nursing clients receive a general practitioner ( GP )‐initiated pharmacist‐led Home Medicines Review, despite their eligibility and community nurses' ( CN ) efforts to facilitate this. An integrated home nursing clinical pharmacy service, in which CN s directly referred clients to a pharmacist, was therefore developed and piloted. The aim was to explore the number and type of medication‐related problems ( MRP s) and medication treatment authorization (medication order) discrepancies identified and addressed by clinical pharmacists. Methods Two part‐time clinical pharmacists were employed. They reviewed and reconciled clients' medications, educated clients/carers about their medicines, provided advice and support to CN s and worked with clients' GP s and other prescribers to optimize medication regimens and revise/update nurses' medication treatment authorizations. Evaluation involved review of clients' medicines data, including treatment authorizations and pharmacist medication review reports. Results and discussion Eighty‐four clients (median 86 years, 6 health conditions, 13 medications) were reviewed. The pharmacists identified 334 MRP s (median 4 per client) and 307 medication discrepancies in treatment authorizations (median 2 per client). The pharmacists made 282 recommendations to prescribers to address MRP s; 148 (52.5%) recommendations were acted on, resulting in 190 medication changes for 60 (71.4%) clients (median 2 per client). The pharmacists prepared, or assisted GP s to update, treatment authorizations for 68 (81%) clients. What is new and conclusion Integrating pharmacists into a home nursing service identified and addressed MRP s and medication treatment authorization discrepancies, hence contributing to enhanced medication safety.