Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2015 Sep;56(9):493-501.
doi: 10.11622/smedj.2015133.

Pharmacist review and its impact on Singapore nursing homes

Hui Shan Chia  1 , John Aik Hui Ho  2 , Bernadette Daolin Lim  3
Affiliations
Multicenter Study

Pharmacist review and its impact on Singapore nursing homes

Hui Shan Chia et al. Singapore Med J. 2015 Sep.

Abstract

Introduction: There is a high prevalence of polypharmacy and inappropriate medication use in Singapore nursing homes. This study primarily explored the benefits of pharmacist reviews in local nursing homes. The secondary aims were to review the potential cost savings gained from following the pharmacists' recommendations and to identify the possible risks associated with polypharmacy and inappropriate medication use.

Methods: A retrospective period prevalence study was performed. We analysed the pharmacotherapy problems highlighted by pharmacists in three nursing homes and the rate of acceptance of pharmacists' recommendations. Data was collected in two phases: (a) a one-month pre-setup period, during which 480 patients were reviewed (i.e. one-time review before weekly pharmacist visits); and (b) a six-month post-setup period, during which the 480 patients were reviewed again. Pharmacotherapy problems were classified according to a clinical pharmacist recommendation taxonomy and potential risks were identified. Monthly cost savings were calculated and compared with the monthly costs of pharmacist reviews.

Results: A total of 392 pharmacotherapy problems were identified, with pharmacist recommendations noted for each problem. Among the 392 recommendations, 236 (60.2%) were accepted. The pharmacotherapy problems were analysed for potential risks, including falls (16.0%) and constipation (13.1%). The acceptance rates were higher during the post-setup period compared to the pre-setup period (p < 0.0001). Total direct acquisition cost savings during the pre- and post-setup periods were SGD 388.30 and SGD 876.69, respectively.

Conclusion: The provision of pharmaceutical care to nursing home residents resulted in improved medication safety and quality of care.

Keywords: Singapore; nursing homes; pharmacists.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flowchart shows details of residents and phases of data collection in the three nursing homes (NH1–3).
See this image and copyright information in PMC

References

    1. Mamun K, Lien CT, Goh-Tan CY, Ang WS. Polypharmacy and inappropriate medication use in Singapore nursing homes. Ann Acad Med Singapore. 2004;33:49–52. - PubMed
    1. Stafford AC, Alswayan MS, Tenni PC. Inappropriate prescribing in older residents of Australian care homes. J Clin Pharm Ther. 2011;36:33–44. - PubMed
    1. Halvorsen KH, Ruths S, Granas AG, Viktil KK. Multidisciplinary intervention to identify and resolve drug-related problems in Norwegian nursing homes. Scand J Prim Health Care. 2010;28:82–8. - PMC - PubMed
    1. Forsetlund L, Eike MC, Gjerberg E, Vist GE. Effect of interventions to reduce potentially inappropriate use of drugs in nursing homes: a systematic review of randomised controlled trials. BMC Geriatr. 2011;11:16. - PMC - PubMed
    1. Tamura BK, Bell CL, Inaba M, Masaki KH. Outcomes of polypharmacy in nursing home residents. Clin Geriatr Med. 2012;28:217–36. - PubMed

Publication types