Department of Internal Medicine section Pharmacotherapy, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands.
Research and Expertise Center in Pharmacotherapy Education (RECIPE), Amsterdam, The Netherlands.
Clin Pharmacol Ther. 2022 Apr;111(4):931-938. doi: 10.1002/cpt.2475. Epub 2021 Nov 17.
As the population ages, more people will have comorbid disorders and polypharmacy. Medication should be reviewed regularly in order to avoid adverse drug reactions and medication-related hospital visits, but this is often not done. As part of our student-run clinic project, we investigated whether an interprofessional student-run medication review program (ISP) added to standard care at a geriatric outpatient clinic leads to better prescribing. In this controlled clinical trial, patients visiting a memory outpatient clinic were allocated to standard care (control group) or standard care plus the ISP team (intervention group). The medications of all patients were reviewed by a review panel ("gold standard"), resident, and in the intervention arm also by an ISP team consisting of a group of students from the medicine and pharmacy faculties and students from the higher education school of nursing for advanced nursing practice. For both groups, the number of STOPP/START-based medication changes mentioned in general practitioner (GP) correspondence and the implementation of these changes about 6 weeks after the outpatient visit were investigated. The data of 216 patients were analyzed (control group = 100, intervention group = 116). More recommendations for STOPP/START-based medication changes were made in the GP correspondence in the intervention group than in the control group (43% vs. 24%, P = < 0.001). After 6 weeks, a significantly higher proportion of these changes were implemented in the intervention group (19% vs. 9%, P = 0.001). The ISP team, in addition to standard care, is an effective intervention for optimizing pharmacotherapy and medication safety in a geriatric outpatient clinic.
随着人口老龄化,越来越多的人将同时患有多种疾病和服用多种药物。为了避免药物不良反应和与药物相关的住院治疗,应定期审查药物,但这通常没有做到。作为我们学生管理的诊所项目的一部分,我们研究了在老年门诊中增加一个跨专业学生管理药物审查计划(ISP)是否会改善处方。在这项对照临床试验中,访问记忆门诊的患者被分配到标准护理(对照组)或标准护理加 ISP 团队(干预组)。所有患者的药物都由审查小组(“黄金标准”)、住院医师审查,在干预组中,还由一组来自医学和药学系以及高等护理学校的学生组成的 ISP 团队审查。对于这两组,研究了在全科医生(GP)通信中提到的基于 STOPP/START 的药物更改数量,以及这些更改在门诊就诊后约 6 周内的实施情况。分析了 216 名患者的数据(对照组=100 名,干预组=116 名)。在干预组的 GP 通信中提出了更多基于 STOPP/START 的药物更改建议(43%对 24%,P<0.001)。6 周后,这些更改中有更高比例在干预组中得到实施(19%对 9%,P=0.001)。除了标准护理外,ISP 团队还是优化老年门诊药物治疗和药物安全性的有效干预措施。