Evaluation of a pharmacist-led intervention on polypharmacy

Abstract

Aim: In order to ensure that patients use medicines and dressings properly, the pharmacist must understand a patient's medication history, symptoms, and test results. This information helps pharmacists to apply their technical knowledge to the prescription of drugs. In Japan, more than a quarter of the population is over 65 years of age; the country is heading toward a "super-aged" society. It is common for older patients to have more than one disease. Improved healthcare has resulted in easier access to medications. Consequently, the problem of polypharmacy has emerged. In this study, we examined the effect of a pharmacist-led intervention on polypharmacy.

Methods: The study subjects were patients of 65 years of age or older who had visited a pharmacist for a consultation between September 2019 and November 2019. The pharmaceutical consultation content and number of proposals were recorded, and the percentage of prescriptions modified and the percentage of patients who experienced changes in symptoms at 4 weeks after the consultation were calculated.

Results: Three hundred sixty-one patients underwent pharmaceutical consultation. Most patients were 80 years of age or older. For 349 patients (96.7%), the consultation resulted in a prescription change. Before the consultation, the average number of drugs was 7.2. After intervention, this decreased by 1.2 to an average of 6.0 drugs. In addition, polypharmacy with≥6 drugs dropped sharply from 67.3% of patients before the consultation to 53.7% of patients after the consultation. The full pharmacotherapy guidelines in 2015 suggested that 33.7% of drugs require particularly careful dosing. Changes in symptoms at 4 weeks after the pharmacist's consultation occurred in 84.5% of patients.

Conclusion: The results of this study suggest that pharmacists should review the prescriptions of elderly patients. We conducted an active intervention for cases of polypharmacy and observed a decrease in the number of drugs following prescription consultation. Furthermore, a reduction in medicines was suggested on the basis of physical checks and test values. Blood test results allow pharmacists to improve the quality of their advice.