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Prescribing-Assessment Tools for Long-Term Care Pharmacy Practice: Reaching Consensus through a Modified RAND/UCLA
João R Gonçalves1, Betsy L Sleath2, Manuel J Lopes3
1iMed.ULisboa, Social Pharmacy Department, Faculty of Pharmacy, University of Lisbon, 1649-003 Lisboa, Portugal.
Pharmacy (Basel, Switzerland)
|December 23, 2021
Summary
Pharmacists can optimize medication use in long-term care facilities using prescribing-assessment tools. Nine of 24 tools were deemed appropriate, with alternatives to inappropriate medications being a valued feature.
Area of Science:
- Geriatric Pharmacy
- Health Services Research
- Medication Safety
Background:
- Medicines are the primary health technology in Long-Term Care (LTC).
- Potentially inappropriate medication (PIM) use is prevalent among LTC patients.
- Pharmacists are crucial for optimizing medication management in LTC settings.
Purpose of the Study:
- To evaluate the suitability of prescribing-assessment tools for pharmacy practice in institutional LTC settings.
- To identify characteristics and barriers associated with the use of these tools.
Main Methods:
- A modified RAND/UCLA Appropriateness Method was employed.
- Thirteen LTC and hospital pharmacists assessed 24 prescribing-assessment tools.
- Qualitative analysis of participant comments identified tool characteristics and usage barriers.
Main Results:
- Nine out of 24 tools were classified as 'appropriate' for LTC pharmacy practice.
- Three tools were classified as 'inappropriate'.
- The indication of alternatives to PIM was the most appreciated feature.
Conclusions:
- Prescribing-assessment tools can aid pharmacists in optimizing medication use in LTC.
- Key barriers to tool implementation include time constraints, pharmacist shortages, and limited clinical information access.
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