J Am Pharm Assoc (2003). 2021 Nov-Dec;61(6):e93-e98. doi: 10.1016/j.japh.2021.07.003. Epub 2021 Jul 10.
Antiseizure medications are commonly associated with adverse effects including behavioral and cognitive issues, drug interactions, idiosyncratic reactions, and long-term complications, which can lead to non-adherence. At the same time, there are limited reports describing multidisciplinary models of epilepsy care that include pharmacists.
To describe the pharmacist services in an epilepsy clinic for older adults and document the patient care delivered using this design.
A subspecialty older adult epilepsy clinic, embedded within a neurology clinic, in an urban academic medical center.
Integration of pharmacy services to document medication history, provide medication reconciliation, identify medication-related problems, and make interventions.
Data were retrospectively evaluated for the patients seen by the pharmacist and epilepsy team between July 2019 and January 2021. Data were summarized with descriptive statistics.
Fifty-eight patients with a total of 94 encounters (70.7% of all specialty clinic visits) were seen collaboratively by the physician and the pharmacist. The majority of patients were African American (87.9%), aged 63.7 ± 8.2 years, and more frequently male (58.6%), and a high proportion had some baseline memory loss or diagnosis of dementia (53.4%). Medication reconciliation occurred in 94 (100%) encounters. More than half the encounters required reconciliation to the existing medication list by adding medication (55.3 % of encounters) or deleting mediations (53.2% of encounters). Presence of adverse effects was the most common medication-related problem identified (23.4%). Resolutions to the medication-related problems were also reported.
The population of older adults with epilepsy is expected to increase in prevalence. Pharmacists are able to impact medication-related problems in a vulnerable, high-risk patient population. The multidisciplinary model we describe here can be used as a template to provide care in ambulatory care practices involving other neurology specialties with a high proportion of older adult patients.
抗癫痫药物通常与不良反应相关，包括行为和认知问题、药物相互作用、个体反应和长期并发症，这可能导致患者不遵医嘱。与此同时，很少有描述包含药剂师的多学科癫痫护理模式的报告。
描述老年癫痫患者的药剂师服务，并记录使用这种设计提供的患者护理。
该实践是一个附属的老年癫痫诊所，嵌入在城市学术医疗中心的神经病学诊所中。
整合药学服务以记录药物史、提供药物重整、识别药物相关问题并进行干预。
对 2019 年 7 月至 2021 年 1 月期间由药剂师和癫痫团队共同诊治的患者进行回顾性评估。数据用描述性统计进行总结。
共 58 名患者（占专科诊所就诊患者的 70.7%）接受了医生和药剂师的联合治疗，总共进行了 94 次就诊。大多数患者为非裔美国人（87.9%），年龄为 63.7±8.2 岁，男性更为常见（58.6%），且很大比例的患者有基线记忆丧失或痴呆诊断（53.4%）。94 次就诊（100%）都进行了药物重整。超过一半的就诊需要对现有的药物清单进行重整，包括添加药物（55.3%的就诊）或删除药物（53.2%的就诊）。发现的最常见药物相关问题是药物不良反应（23.4%）。还报告了药物相关问题的解决方案。
预计患有癫痫的老年患者人数将会增加。药剂师能够解决高危脆弱患者群体中的药物相关问题。我们在此描述的多学科模式可作为模板，为其他涉及老年患者比例较高的神经病学专业的门诊护理实践提供护理。
