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Comprehensive medication review: development of a collaborative procedure.

Saija Leikola¹, Lea Tuomainen, Sirpa Peura

¹Division of Social Pharmacy, Faculty of Pharmacy, P.O. BOX 56, 00014, University of Helsinki, Finland. saija.leikola@gmail.com

International Journal of Clinical Pharmacy

|June 20, 2012

Summary

This commentary details the development of the Comprehensive Medication Review (CMR) procedure in Finland. The evidence-based CMR process enhances geriatric pharmacotherapy by addressing aging, comorbidities, polypharmacy, and adherence.

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Area of Science:

Pharmacotherapy
Geriatric Medicine
Health Services Research

Background:

Medication reviews are crucial for optimizing pharmacotherapy in geriatric patients.
Existing medication review procedures vary internationally.
A standardized approach is needed for community and hospital settings.

Purpose of the Study:

To describe the development and evidence base of a national Comprehensive Medication Review (CMR) procedure in Finland.
To establish a standardized CMR process for improving geriatric pharmacotherapy.

Main Methods:

A national steering group coordinated the development.
Collaboration with 26 pharmacists during a 1.5-year accreditation training.
Literature review, procedure creation, national standardization, and practical piloting.
Procedure development involved patient interviews and physician case conferences.

Main Results:

A comprehensive medication review (CMR) procedure was developed and piloted.
The procedure integrates patient clinical information, in-home interviews, and physician consultations.
It addresses key geriatric pharmacotherapy dimensions: aging/safety, comorbidities, polypharmacy, and adherence.

Conclusions:

The developed CMR procedure provides a structured framework for medication management in older adults.
This evidence-based approach aims to improve the safety and appropriateness of pharmacotherapy.
The procedure is designed for both community and hospital settings in Finland.