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Assessment of the clinical relevance of implemented recommendations, given by clinical pharmacists, and the significance of identified drug-related problems.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
2018 (English)Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Abstract

 

Background: Drug Related Problems (DRPs) are commonly found in elderly patients. Clinical pharmacists are increasingly performing medication reviews in order to optimise the healthcare given to patients. Previous studies, such as the research on the importance of clinical pharmacist’ recommendations on DRPs and the Lund Integrated Medicines Management-model, show that the services performed by clinical pharmacists result in an improvement in drug therapy for inpatients hospitalised in Sweden. Both studies used the ranking scale developed by Hatoum et al. to rank the clinical significance of given recommendations. Although, there are few studies evaluating the clinical significance of associated identified DRPs, which is done in this investigation.

Aim: To evaluate the clinical significance of identified Drug Related Problems (DRPs) and associated implemented recommendations given by clinical pharmacists to interventions included in the MedBridge study. This was performed in order to estimate if an improved drug therapy is provided to patients included in the MedBridge study.

Materials and method: Patients were randomly selected from the MedBridge study population and studied retrospectively in order to find DRPs with implemented recommendations. The clinical significance of the DRPs and recommendations were then assessed by three experts using a modified Hatoum ranking scale and the original ranking scale respectively. The inter-rater agreement between the three experts’ original rankings was calculated before they reached agreement through discussions in consensus meetings.

Results: In this study, 89 % of the identified DRPs and 85 % of the implemented recommendations were ranked as a score 3 or higher. Cohen’s kappa, the inter-rater agreement, was very low (< 0,2) between all three experts showing a slight inter-rater agreement initially.

Conclusions: The results of this study suggest that the majority of the identified DRPs and implemented recommendations in the MedBridge study are clinically significant. Thus, a better drug therapy was provided to the included patients that underwent thorough medication reconciliation.

Place, publisher, year, edition, pages
2018. , p. 31
Keywords [en]
Drug related problem, Clinical pharmacist, Medication review, LIMM, MedBridge study, recommendation
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-353431OAI: oai:DiVA.org:uu-353431DiVA, id: diva2:1217264
Subject / course
Pharmacotherapy
Educational program
Master of Science Programme in Pharmacy
Supervisors
Examiners
Projects
MedBridgeAvailable from: 2018-06-13 Created: 2018-06-12 Last updated: 2018-06-13Bibliographically approved

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CiteExportLink to record
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