ABSTRACT

Objectives: Adverse drug events (ADE) are a common cause of morbidity and mortality in elderly patients. In this study, we assessed the impact of multidisciplinary medication review (MMR) for nursing home residents on patient safety and costs incurred by the hospital and the national health service.

Methods: Medical files of residents were retrospectively assessed for medications prescribed in the previous six months. A pharmacist reviewed the prescriptions and suggested modifications to the patient’s medical team. Patients were followed for six months. Trivalle’s ADE geriatric risk score was calculated before and after MMR, as were number of potentially inappropriate medications, and economic impact from the perspective of the health care system and the nursing home.

Results: Forty-nine patients were recruited. ADE score dropped one risk level (median score of 4 before versus 1 after, p < 0.0001). The number of patients taking at least one potentially inappropriate medication decreased from 30.6% before to 6.1% after MMR (p = 0.005). A mean saving of €232 per patient was made from the nursing home perspective following MMR (p = 0.008).

Conclusion: The MMR reduced the iatrogenic drug risk for elderly residents and costs from the nursing home perspective, particularly drug expenditure.

摘要

目的：不良药物事件（ADE）是老年患者发病和死亡的常见原因。在这项研究中，我们评估了多学科药物审查（MMR）对疗养院居民对患者安全和医院及国家卫生服务所产生费用的影响。

方法：对居民的医疗档案进行回顾性评估，以评估前六个月开出的药物。一名药剂师检查了处方，并建议对患者的医疗团队进行修改。对患者进行了六个月的随访。从医疗保健系统和疗养院的角度来看，Trivalle的ADE老年风险评分是在MMR前后计算的，潜在不当药物的数量以及对经济的影响也是如此。

结果：招募了49例患者。ADE评分降低了一种风险水平（中位数评分前为4，后为1，p <0.0001）。接受至少一种可能不合适的药物治疗的患者人数从MMR之前的30.6％下降到MMR之后的6.1％（p = 0.005）。从MMR的疗养院角度来看，每位患者平均节省232欧元（p = 0.008）。

结论：MMR从疗养院的角度降低了老年居民的医源性药物风险和成本，尤其是药物支出。