Potential clinical impact of pharmaceutical interventions in an interprofessional medication management program

Abstract

Introduction

Medication reviews (MR) can improve medication safety, especially when followed by continuous medication management (MM). The interprofessional MM program ARMIN resulted in a significantly reduced mortality risk. To gain a deeper understanding of what contributed to this effect, we aimed to investigate the pharmaceutical interventions (PI) conducted by the community pharmacies and their communication with the physicians.

Methods

We conducted an intervention study in the ambulatory setting with a pre-post design and an observational period of approximately 6 months per patient to assess (1) number and types of drug-related problems (DRP) identified and solved, (2) to evaluate PIs conducted, (3) changes in the medication, (4) clinical and economic impact of the PIs, and (5) involvement of the physicians with respect to type and relevance of DRPs.

Results

79 patients received 10.2 drugs at baseline (median: 9, range 5–26). (1) 420 DRPs were detected during the initial MR and 50 DRPs during MM. (2) 538 PIs were conducted. (3) Changes in the medication were observed in all patients. (4) 404 PIs (76.0%) were classified as successfully implemented. Of these, 84.2% had minor and 12.6% moderate clinical impact. Most of the PIs (81.9%) had no effect on costs. (5) In 42.2% (n = 227) of PIs, the prescribing physician was contacted.

Conclusion

Within ARMIN it was possible to solve DRPs with PIs resulting in changes in medication and having a potential clinical impact. The implementation rate shows that intensive collaboration with clear responsibilities between CP and physician is crucial.