Pharmacists' Recommendations to Reduce Drug Therapy Problems in Nursing Home Residents

Pharmacy Practice

  • Katarina Fehir Šola1Assistant professor, PhD, MPh, Department of laboratory medicine and pharmacy, Faculty of Medicine Osijek, University Josip Juraj Strossmayer Osijek, 31 000 Osijek, Croatia.
  • Ljubica Frančić Pranjković2MPh, Pharmacy Vaše zdravlje, 10 000 Zagreb, Croatia.
  • Pero Hrabač3PhD, MD, Department of Medical Statistics, Epidemiology and Medical Informatics "Andrija Štampar" School of Public Health, School of Medicine, University of Zagreb, 10 000 Zagreb, Croatia.
  • Iva Bužančić4PhD, MPh, City pharmacies Zagreb, 10 000 Zagreb, Croatia.

Volume 23 Issue 2 Pages 1-10

DOI: 10.18549/PharmPract.2025.2.3196

Abstract

Objective: Comprehensive Medication Management Services (CMM) are clinical services based on pharmaceutical care, and represents a patient-centred approach in which the pharmacist takes the responsibility for the patient's needs. This study aimed to describe drug therapy problems among nursing home residents, identified through pharmacists' provision of CMM, and assess physicians' acceptance of pharmacists' recommendations. Methods: A cross-sectional observational study was conducted from February 2018 to January 2019 in a nursing home in Croatia. Utilizing the Pharmacotherapy Workup method by Cipolle et al., pharmacists assessed and classified DTPs related to indication, effectiveness, safety, and adherence. Recommendation included medication discontinuation, dose adjustments and patient education. Results: Sixty residents were included in the study. Median age was 79.9 (IQR 66.1 – 96.7) years. On average, residents used 7 (IQR 2–16) medications and had 5 (IQR 1–12) comorbidities. In total, 141 DTPs were identified (4.3 ± SD2.35 per resident). The most prevalent DTP was "additional drug therapy needed" (n =55; 39%), falling into the effectiveness category. The pharmacists suggested 133 modifications for the identified DTPs. Physicians accepted a total number of 112 recommendations (84.21%). Conclusion: The high prevalence of DTPs identified and substantial acceptance of pharmacists' recommendations strongly suggests the need to incorporate CMM services within long-term care facilities with intent to improve quality of care. The results demonstrate that pharmacists are pivotal in optimizing therapeutic outcomes through effective medication management.

Keywords

  • drug therapy problem
  • elderly
  • pharmacists' recommendation
Pharmacy Practice

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