How a Patient Personalised Clinical Pharmacy Programme Can Secure Therapeutic Care in an Orthogeriatric Care Pathway (5P Project)?
clinical relevance
frail elderly
hip fracture
medication errors
pharmaceutical services
Journal
Clinical interventions in aging
ISSN: 1178-1998
Titre abrégé: Clin Interv Aging
Pays: New Zealand
ID NLM: 101273480
Informations de publication
Date de publication:
2021
2021
Historique:
received:
19
06
2021
accepted:
23
09
2021
entrez:
28
10
2021
pubmed:
29
10
2021
medline:
26
11
2021
Statut:
epublish
Résumé
A new model was developed for integrating a personalised clinical pharmacy programme (5P project) into the orthogeriatric care pathway. To secure the therapeutic care of orthogeriatric patients. Prospective descriptive study in a multisite teaching hospital from June 2019 to January 2020. Patients aged ≥75 years admitted for hip fracture. A prescription review was performed for all patients at inclusion. Other clinical pharmacy activities (additional prescription review, pharmaceutical interviews, medication reconciliation) were dedicated to "high-risk" patients. Potential medication errors (ME), either pharmaceutical interventions (PI) or unintentional discrepancies (UID), were recorded. The potential clinical impact of PI was evaluated by a pluriprofessional expert panel using a validated tool. In the 455 patients included, 955 potential ME were detected, that is ≥1 potential ME for 324/455 (71%) patients. In acute care, 561 PI were formulated during prescription review for 440/455 (97%) patients and 348/561 (62%) were accepted by physicians. Medication reconciliation was performed for 213 patients, 316 UID were identified. In rehabilitation units, a second prescription review was performed for 112/122 (92%) "high-risk" patients, leading to 61 PI. The clinical impact was evaluated for 519/622 (83%) PI. A consensus was obtained for 310/519 (60%) PI: 147/310 (47%) were rated as having minor clinical impact, 138/310 (45%) moderate, 22/310 (7%) major, 2/310 (0.6%) vital, and 1/310 (0.3%) null. The 5P project secured the orthogeriatric care pathway by detecting a great number of potential ME, including PI mostly considered as having a significant clinical impact.
Sections du résumé
BACKGROUND
BACKGROUND
A new model was developed for integrating a personalised clinical pharmacy programme (5P project) into the orthogeriatric care pathway.
OBJECTIVE
OBJECTIVE
To secure the therapeutic care of orthogeriatric patients.
DESIGN AND SETTING
METHODS
Prospective descriptive study in a multisite teaching hospital from June 2019 to January 2020.
SUBJECTS
METHODS
Patients aged ≥75 years admitted for hip fracture.
METHODS
METHODS
A prescription review was performed for all patients at inclusion. Other clinical pharmacy activities (additional prescription review, pharmaceutical interviews, medication reconciliation) were dedicated to "high-risk" patients. Potential medication errors (ME), either pharmaceutical interventions (PI) or unintentional discrepancies (UID), were recorded. The potential clinical impact of PI was evaluated by a pluriprofessional expert panel using a validated tool.
RESULTS
RESULTS
In the 455 patients included, 955 potential ME were detected, that is ≥1 potential ME for 324/455 (71%) patients. In acute care, 561 PI were formulated during prescription review for 440/455 (97%) patients and 348/561 (62%) were accepted by physicians. Medication reconciliation was performed for 213 patients, 316 UID were identified. In rehabilitation units, a second prescription review was performed for 112/122 (92%) "high-risk" patients, leading to 61 PI. The clinical impact was evaluated for 519/622 (83%) PI. A consensus was obtained for 310/519 (60%) PI: 147/310 (47%) were rated as having minor clinical impact, 138/310 (45%) moderate, 22/310 (7%) major, 2/310 (0.6%) vital, and 1/310 (0.3%) null.
CONCLUSION
CONCLUSIONS
The 5P project secured the orthogeriatric care pathway by detecting a great number of potential ME, including PI mostly considered as having a significant clinical impact.
Identifiants
pubmed: 34707352
doi: 10.2147/CIA.S325035
pii: 325035
pmc: PMC8544550
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1857-1867Informations de copyright
© 2021 Barral et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
Eur J Intern Med. 2014 Nov;25(9):808-14
pubmed: 25277510
Am J Geriatr Pharmacother. 2010 Apr;8(2):127-35
pubmed: 20439062
J Patient Saf. 2018 Oct 25;:
pubmed: 30365407
BMJ Open. 2016 Feb 23;6(2):e010003
pubmed: 26908524
Arch Osteoporos. 2013;8:137
pubmed: 24113838
J Pharm Pract. 2012 Apr;25(2):136-41
pubmed: 22048929
Age Ageing. 2017 May 1;46(3):465-470
pubmed: 27974304
Geriatr Orthop Surg Rehabil. 2016 Mar;7(1):18-22
pubmed: 26929852
Arch Intern Med. 2009 May 11;169(9):894-900
pubmed: 19433702
PLoS One. 2014 Jan 15;9(1):e83795
pubmed: 24454708
Clin Interv Aging. 2016 Sep 26;11:1343-1350
pubmed: 27713625
Lancet. 2015 Apr 25;385(9978):1623-33
pubmed: 25662415
Injury. 2018 Aug;49(8):1458-1460
pubmed: 29699731
Eur J Clin Pharmacol. 2007 Aug;63(8):725-31
pubmed: 17554532
J Clin Pharm Ther. 2018 Apr;43(2):240-248
pubmed: 29143347
BMC Geriatr. 2020 Jan 13;20(1):13
pubmed: 31931723
Br J Clin Pharmacol. 2004 Apr;57(4):513-21
pubmed: 15025751
Res Social Adm Pharm. 2021 Aug 8;:
pubmed: 34389258
Eur J Hosp Pharm. 2018 Mar;25(e1):e74-e81
pubmed: 31157072