TY - JOUR
T1 - To what extent is clinical and laboratory information used to perform medication reviews in the nursing home setting? The CLEAR study
AU - Gonzalvo, Carlota Mestres
AU - Hurkens, Kim P.G.M.
AU - De Wit, Hugo A.J.M.
AU - Van Oijen, Brigit P.C.
AU - Janknegt, Rob
AU - Schols, Jos M.G.A.
AU - Mulder, Wubbo J.
AU - Verhey, Frans R.
AU - Winkens, Bjorn
AU - Van Der Kuy, Paul Hugo M.
N1 - Publisher Copyright:
© 2015 Gonzalvo et al.
PY - 2015/5/8
Y1 - 2015/5/8
N2 - Background: The aim of this study was to evaluate to what extent laboratory data, actual medication, medical history, and/or drug indication influence the quality of medication reviews for nursing home patients. Methods: Forty-six health care professionals from different fields were requested to perform medication reviews for three different cases. Per case, the amount of information provided varied in three subsequent stages: stage 1, medication list only; stage 2, adding laboratory data and reason for hospital admission; and stage 3, adding medical history/drug indication. Following a slightly modified Delphi method, a multidisciplinary team performed the medication review for each case and stage. The results of these medication reviews were used as reference reviews (gold standard). The remarks from the participants were scored, according to their potential clinical impact, from relevant to harmful on a scale of 3 to -1. A total score per case and stage was calculated and expressed as a percentage of the total score from the expert panel for the same case and stage. Results: The overall mean percentage over all cases, stages, and groups was 37.0% when compared with the reference reviews. For one of the cases, the average score decreased significantly from 40.0% in stage 1, to 30.9% in stage 2, and 27.9% in stage 3; no significant differences between stages was found for the other cases. Conclusion: The low performance, against the gold standard, of medication reviews found in the present study highlights that information is incorrectly used or wrongly interpreted, irrespective of the available information. Performing medication reviews without using the available information in an optimal way can have potential implications for patient safety.
AB - Background: The aim of this study was to evaluate to what extent laboratory data, actual medication, medical history, and/or drug indication influence the quality of medication reviews for nursing home patients. Methods: Forty-six health care professionals from different fields were requested to perform medication reviews for three different cases. Per case, the amount of information provided varied in three subsequent stages: stage 1, medication list only; stage 2, adding laboratory data and reason for hospital admission; and stage 3, adding medical history/drug indication. Following a slightly modified Delphi method, a multidisciplinary team performed the medication review for each case and stage. The results of these medication reviews were used as reference reviews (gold standard). The remarks from the participants were scored, according to their potential clinical impact, from relevant to harmful on a scale of 3 to -1. A total score per case and stage was calculated and expressed as a percentage of the total score from the expert panel for the same case and stage. Results: The overall mean percentage over all cases, stages, and groups was 37.0% when compared with the reference reviews. For one of the cases, the average score decreased significantly from 40.0% in stage 1, to 30.9% in stage 2, and 27.9% in stage 3; no significant differences between stages was found for the other cases. Conclusion: The low performance, against the gold standard, of medication reviews found in the present study highlights that information is incorrectly used or wrongly interpreted, irrespective of the available information. Performing medication reviews without using the available information in an optimal way can have potential implications for patient safety.
UR - http://www.scopus.com/inward/record.url?scp=84930203831&partnerID=8YFLogxK
U2 - 10.2147/TCRM.S77428
DO - 10.2147/TCRM.S77428
M3 - Article
C2 - 26056459
AN - SCOPUS:84930203831
SN - 1176-6336
VL - 11
SP - 767
EP - 777
JO - Therapeutics and Clinical Risk Management
JF - Therapeutics and Clinical Risk Management
ER -