Clinical results of an inter-professional student-led medication review program

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Abstract

Introduction: Medicine is becoming increasingly specialized with specific referral questions and clearly defined outpatient clinic goals. An inter-professional student-led medication review program (ISP) team reviewing medication in geriatric patients has shown promising results. Besides getting trained in practising medication evaluation this team could increase medication safety. Objectives: We analyzed the added value of an ISP-team on top of standard care in regard to adverse drug reactions (ADRs), potentially inappropriate prescriptions (PIPs) and potential prescribing omissions (PPO). Methods: We performed a randomized controlled trial where a varying team of healthcare students (ISP-team) review two of the four patients visiting the memory clinic. After amedication review the students discuss their findings in a multidisciplinary meeting and update the electronic patient system. After each patients visit, medication advices of the control group (physician without ISP-team) and intervention group (physician with ISP-team) are compared to the START-STOPP criteria. A followupmedication overview is requested from the local pharmacist to analyze applied changes after one month. Results: So far 37 patients (23 control and 14 intervention) have been analyzed. ADRs were more frequently reported by the ISP (36%) than by the physician (19%). PIPs and PPOs were more often correctly addressed in the correspondence letter in the intervention group (PIPs 50%, PPOs 79%) than in the control group (PIPs 40%, PPOs 60%). In 14% and 36% the physician revised their advice regarding PIPs and PPOs because of the ISP-advice. These advices were related to stopping acetylsalicylic acid and tamsulosin and starting vitamin D and statin treatment. During the outpatient clinic visit 13% of PIPs and 83% of PPOs were directly changed, instead of giving the advice to the general practitioner. One month after the correspondence letter 63% of PIPs and 92% PPOs were corrected. Summary / Conclusions: These preliminary results show that the addition of an ISP-team on top of standard care is effective in increasing the number of ADRs and reducing the number of PIPs and PPOs in the outpatient clinic correspondence letters. Most advices have actually reached the patient and could prevent future medication related harm. Since the study is still in progress we will continue including patients and show 3-month follow-up data regarding treatment satisfaction and ADR outcome.
Original languageEnglish
Pages (from-to)S62
JournalEuropean Journal of Clinical Pharmacology
Volume75
DOIs
Publication statusPublished - 2019

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