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Am J Health Syst Pharm. 2009 May 1;66(9):854-9. doi: 10.2146/ajhp080176.

Effects of an integrated medicines management program on medication appropriateness in hospitalized patients.

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Pharmacy Practice, Department of Pharmacy and Pharmaceutical Sciences, School of Biomedical Sciences, University of Ulster, Coleraine, County Antrim, Northern Ireland, United Kingdom.



The effects of an integrated medicines management (IMM) program on medication appropriateness are discussed.


Patients enrolled in an IMM project within a hospital were randomly allocated to either a control or an intervention group. Patients in the control group received standard pharmaceutical care, while the intervention patients received the IMM service. The appropriateness of the medications prescribed was estimated on admission and discharge using the Medicines Appropriateness Index (MAI), which ranged from 0 (no prescribing problems) to 18 (most prescribing problems). For each medication scored, the difference between admission and discharge MAI scores for individual patients was calculated.


Scoring was completed on 1711 medications prescribed for 117 patients. There was a statistically significant difference (p = 0.03) in the mean MAI scores on discharge between the intervention and control groups (5.69 versus 9.97, respectively). There was also a statistically significant difference (p = 0.00003) in the mean MAI scores on admission and discharge (17.48 versus 5.69, respectively) for the intervention group. The intervention group had a mean +/- S.D. difference of -11.78 +/- 14.64, while the control group had a mean +/- S.D. difference of -3.19 +/- 11.80. The difference was statistically significant (p = 0.0011) between the two groups.


This study demonstrated significant improvements in the appropriateness of medications on discharge for patients receiving an IMM service compared with patients who did not receive this service.

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