Comparison of two methods for performing treatment reviews by pharmacists and general practitioners for home-dwelling elderly people

Abstract

Rationale, aims and objectives: There is room for improvement in pharmacotherapy for elderly outpatients. Studies have shown that collaborating health care professionals [e.g. pharmacists in cooperation with general practitioners (GPs)] are able to resolve prescription-related pharmaceutical care issues by means of treatment reviews. The aim of the study was to describe the feasibility of two methods for treatment review (results were given to the GP either in case conferences or in written feedback), and to determine if and how the process of treatment review can be improved.

Setting: Local pharmacists and GPs cooperated in performing treatment reviews for outpatients aged 75 years or more who were using five or more medicines chronically.

Method: Written questionnaires, structured telephone interviews and analysis of various features of the treatment reviews that were recorded during the intervention study were used.

Results: The pharmacists in the case conference group made more recommendations to the GPs (non-significant). Significantly more recommendations were identified by the pharmacists themselves in the case conference group. Health care professionals accepted an intervention with personal contact in case conferences better than an intervention with feedback in writing. They were more positive about the process of treatment review presented personally, although there were not always as many medication changes as they had hoped for. They also had concrete suggestions for improving the intervention, such as using a combination of written feedback and case conferences, and reserving the case conferences for the most complex cases.

Conclusions: Treatment reviews for the elderly in normal primary care are feasible. Health care professionals agree that the process for treatment review can be improved.