A Collaborative Medication Review Including Deprescribing for Older Patients in an Emergency Department: A Longitudinal Feasibility Study

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Morten Baltzer Houlind, Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen Ø, Denmark.
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  • Aino Leegaard Andersen, Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark.
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  • Charlotte Treldal, Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen Ø, Denmark.
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  • Lillian Mørch Jørgensen, Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark.
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  • Pia Nimann Kannegaard, Department of Geriatric Medicine, Copenhagen University Hospital Herlev and Gentofte, 2900 Hellerup, Denmark.
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  • Luana Sandoval Castillo, Department of Geriatrics, Copenhagen University Hospital Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark.
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  • Line Due Christensen
  • Juliette Tavenier, Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark.
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  • Line Jee Hartmann Rasmussen, Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark., Department of Psychology and Neuroscience, Duke University, 27708 Durham, NC, USA.
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  • Mikkel Zöllner Ankarfeldt, Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark., Copenhagen Phase IV unit (Phase4CPH), Center of Clinical Research and Prevention and Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, 2000 Copenhagen, Denmark..
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  • Ove Andersen, Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark., Emergency Department, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark..
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  • Janne Petersen, Clinical Research Centre, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark., Copenhagen Phase IV unit (Phase4CPH), Center of Clinical Research and Prevention and Department of Clinical Pharmacology, Copenhagen University Hospital Bispebjerg and Frederiksberg, 2000 Copenhagen, Denmark.., Department of Public Health, Section of Biostatistics, University of Copenhagen, 5 Øster Farimagsgade, DK-1014 Copenhagen, Denmark.

Medication review for older patients with polypharmacy in the emergency department (ED) is crucial to prevent inappropriate prescribing. Our objective was to assess the feasibility of a collaborative medication review in older medical patients (≥65 years) using polypharmacy (≥5 long-term medications). A pharmacist performed the medication review using the tools: Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, a drug-drug interaction database (SFINX), and Renbase® (renal dosing database). A geriatrician received the medication review and decided which recommendations should be implemented. The outcomes were: differences in Medication Appropriateness Index (MAI) and Assessment of Underutilization Index (AOU) scores between admission and 30 days after discharge and the percentage of patients for which the intervention was completed before discharge. Sixty patients were included from the ED, the intervention was completed before discharge for 50 patients (83%), and 39 (61.5% male; median age 80 years) completed the follow-up 30 days after discharge. The median MAI score decreased from 14 (IQR 8-20) at admission to 8 (IQR 2-13) 30 days after discharge (p < 0.001). The number of patients with an AOU score ≥1 was reduced from 36% to 10% (p < 0.001). Thirty days after discharge, 83% of the changes were sustained and for 28 patients (72%), 1≥ medication had been deprescribed. In conclusion, a collaborative medication review and deprescribing intervention is feasible to perform in the ED.

OriginalsprogEngelsk
Artikelnummer348
TidsskriftJournal of Clinical Medicine
Vol/bind9
Nummer2
Antal sider16
ISSN2077-0383
DOI
StatusUdgivet - 2020

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