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Acta Clin Belg. 2019 Jun 26:1-9. doi: 10.1080/17843286.2019.1634323. [Epub ahead of print]

Application of the GheOP3S-tool in nursing home residents: acceptance and implementation of pharmacist recommendations.

Author information

1
a Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences , Ghent University , Ghent , Belgium.
2
b Department of Family Medicine and Primary Health Care, Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium.
3
c Department of Pharmacy , Ghent University Hospital , Ghent , Belgium.
4
d Department of Internal Medicine and Pediatrics, section of Geriatrics, Faculty of Medicine and Health Sciences , Ghent University , Ghent , Belgium.

Abstract

Background and objective: The prevalence of potentially inappropriate prescribing (PIP) among nursing home (NH) residents is high. This study aimed to investigate the acceptance and implementation of pharmacist recommendations based on a screening tool for PIP, the Ghent Older People's Prescriptions community Pharmacy Screening (GheOP3S)-tool. Setting and method: Prospective observational study in NH residents (≥ 70 years, using ≥ 5 medications) with a 3-month follow-up period. A pharmacist screened the medication lists using the GheOP3S-tool and formulated recommendations to reduce PIP. The acceptance of recommendations discussed during face-to-face pharmacist-general practitioner (GP) meetings was recorded. Implementation was examined by comparing baseline and follow-up medication lists. A pre-post comparison of the number of chronic medications and GheOP3S-criteria; the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI); and medication costs was performed. Results: Screening with the GheOP3S-tool resulted in 168 pharmacist recommendations for 50 NH residents, mainly to stop (78.0%) and to substitute (14.3%) medications. Ninety-three % (156/168) of recommendations were considered relevant. GPs acceptance rate was 44.9%. Fifty-four % of all accepted recommendations were implemented. At follow-up, the number of chronic medications (p = 0.007), and DBI scores (p = 0.004) significantly differed from baseline. There was no significant decrease in the number of GheOP3S-criteria (p = 0.075) and medication costs (p > 0.05). Conclusion: The acceptance and implementation of pharmacist recommendations were relatively low. Future studies should increase the involvement of patients and all health-care providers. Interdisciplinary collaboration with sufficient education for all disciplines and patients is essential.

KEYWORDS:

Potentially inappropriate prescribing; medication review; nursing home; pharmacist; polypharmacy

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