Home-Based Comprehensive Medication Reviews: Pharmacist's Impact on Drug Therapy Problems in Geriatric Patients

Abstract

Objective: To evaluate the effects of pharmacist-conducted, home-based comprehensive medication reviews (CMRs) on drug therapy problems (DTPs) in geriatric patients.

Design: Pre-/postintervention study.

Setting: Grocery store chain affiliated with three independent living facilities.

Participants: Twenty-five older adults using pharmacy delivery services for at least three chronic medications.

Intervention: A pharmacist conducted a home-based CMR for each participant. DTPs were identified across 13 categories. Patients received a medication action plan post-CMR. A follow-up patient phone call was completed two weeks following the appointment. Patient profiles were reviewed for three months postintervention for changes in DTPs.

Main outcome measures: Changes in DTPs per patient and changes in five Centers for Medicare & Medicaid Services triple-weighted Star Rating performance measures.

Results: The average DTPs identified per patient were reduced from 3.4 ± 2.06 to 1.48 ± 1.68 (P < 0.05) DTPs three months postintervention. The most common categories identified-nonadherence and incorrect administration/ technique-were significantly reduced (P = 0.012 and P = 0.010, respectively). One Star Rating performance measure significantly improved: 68% of patients taking hypertension medications were adherent at baseline and 91% were adherent three months post-CMR (P = 0.016).

Conclusion: Pharmacist-provided, home-based CMRs reduced the average number of DTPs per patient. The most common categories of DTPs identified-nonadherence and incorrect administration/technique-were reduced postintervention.