Multi-professional medication review in home care and care homes

Background and objectives: Polypharmacy and drug related problems (DRPs) are common in elderly people [1]. The emphasis of geriatric care has moved towards home care and care homes. Our objective was to develop a multidisciplinary medication review (MMR) practice to rationalise medication in care homes. Method(s): People who potentially have DRPs are recognised through a screening-tool based on Resident Assessment Instrument (RAI) by nurse (Fig. 1). Clinical pharmacist prepares a report of medication changes based on DRPs. The report is discussed by nurse, doctor and pharmacist. Doctor defines medication changes and follow-up. Nurse and practical nurse put changes into action, monitor patient's condition daily and report changes to doctor. The project was regarded as development of practice, and therefore no ethical approval was sought. Result(s): Our practice was piloted in two care homes (n = 90). A convenient sample was used. The screen recognised 28 people and 23 of them had MMR. Clinical pharmacist proposed altogether 102 medication changes and 46.1 %(n = 47) of them were put into action. Themost common types of changes were changing dose (n = 32), removing a medicine (n = 25) and addition of amedicine (n = 22). Also laboratory tests or other tests to control medication were suggested. Conclusion(s): RAI-system can be utilized in recognising elderly people with DRPs. Our pilot-project indicated that the strength of MMR is going through the whole medication carefully, while usual care concentrates in the most acute issues. Long-term outcomes of our MMR practice should be discovered in future. (Figure Presented).

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