Patient-Centered Pharmacy Services: A Descriptive Report

Area of Science:

• Geriatric Pharmacy
• Clinical Pharmacy Services
• Medication Safety

Background:

• Long-term care facilities house vulnerable populations requiring specialized medication management.
• Medication-related problems are prevalent in older adults, increasing morbidity and mortality.
• Interprofessional collaboration is crucial for comprehensive patient care.

Purpose of the Study:

• To describe a proactive, patient-centered, interprofessional approach to medication review in a long-term care (LTC) setting.
• To evaluate the process outcomes of clinical pharmacy services provided to LTC residents.
• To determine the impact of pharmacist interventions on medication regimen safety and appropriateness.

Main Methods:

• Implementation of comprehensive clinical pharmacy services, including medication reconciliation and monitoring in high-risk areas.
• Systematic review of medication regimens for LTC residents.
• Documentation and analysis of pharmacist recommendations and physician acceptance rates.
• Evaluation of process outcomes: number of reviews, recommendations made, and acceptance rates.

Main Results:

• 1,333 medication regimen reviews were conducted.
• 274 recommendations were made, with 218 acknowledged by physicians.
• Physicians accepted 72% (157/218) of acknowledged recommendations.
• The service identified and resolved potential drug-related problems, including inappropriate medications and drug interactions.

Conclusions:

• A proactive, interprofessional approach to medication review significantly enhances patient safety in LTC facilities.
• Regular pharmacist involvement is critical for identifying and mitigating drug-related problems.
• The high volume of reviews and recommendations highlights the need for dedicated clinical pharmacy services in LTC settings.