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Analysis of pharmacists’ medication review activities within Care Home Independent Pharmacists Prescribing Study (CHIPPS): Process evaluation

  • At: PPR SIG 2021 (2021)
  • Type: Digital
  • By: ALHARTHI, Mohammed (University of East Anglia, United Kingdom)
  • Co-author(s): Mohammed Alharthi, David Wright
  • Abstract:

    Introduction

    Medication reviews (MR) by clinical pharmacists in care homes, are designed to optimise medication use for residents thereby enhancing quality of life, reducing medication adverse events such as falls risk and reducing the Drug Burden Index (DBI).

    Objectives

    The objective is to evaluate the effects of MR activities conducted by clinical pharmacists in the CHIPPS study concerning falls risk and DBI.

    Methods

    370 care plans created by 22 pharmacist independent prescribers undertaking medication reviews over a six-month period in 40 care homes for 449 residents across England, Scotland and Northern Ireland were analysed. With 424 residents in the control arm, the primary outcome measure was falls. Interventions were classified as medicines stopped (deprescribed), dose reduced, dose increased, and new medicine started. Each activity was then analysed to determine potential impact on falls risk and Drug Burden.

    Results

    22 PIPs recorded 566 clinical interventions of which 343 were to stop medicines or reduce doses and 86 to start medicines or increase doses. 124 clinical interventions were associated with a reduction in falls risk and 37 with an increase. Regarding DBI, 180 activities were associated with a DBI score reduction, and 10 with a DBI score increase.

    Conclusion

    The study showed that less than a quarter of the residents experienced an intervention to reduce falls risk but almost forty percent realised a reduction in drug burden. The results from the process evaluation suggest that falls may not be the most appropriate primary outcome measure.

Last update 4 October 2019

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