A1 Journal article – refereed
Can Practical Nurses Identify Older Home Care Clients at Risk of Drug-Related Problems-Geriatricians' Appraisal of Their Risk Screenings: A Pilot Study




List of Authors: Dimitrow M, Puustinen J, Viikari P, Puumalainen E, Vahlberg T, Airaksinen MSA, Kivelä SL
Publisher: SAGE PUBLICATIONS INC
Publication year: 2018
Journal name in source: JOURNAL OF PHARMACY TECHNOLOGY
Journal acronym: J PHARM TECHNOL
Volume number: 34
Issue number: 3
Number of pages: 10
ISSN: 8755-1225

Abstract
Background: Home care (HC) clients are increasingly older, have many chronic diseases, and use multiple medicines and thus are at high risk for drug-related problems (DRPs). Objective: Establish the sensitivity of practical nurse (PN) administered DRP risk assessment tool (DRP-RAT) compared with geriatrician's assessment of the medical record. Identify the clinically most significant DRPs needing action. Methods: Twenty-six PNs working in HC of Harkatie Health Center in Lieto, Finland, 46 HC clients (>= 65 years), and a geriatrician participated in this pilot study. The geriatrician reviewed HC clients' medications using 3 different methods. The reviews were based on the following: (1) the PN's risk screening (ie, PN-completed DRP-RAT) and medication list, (2) health center's medical records, and (3) methods 1 and 2 together. The main outcome was the number of "at-risk patients" (ie, the patient is at risk of clinically significant DRPs) by using each review method. Secondary outcomes were clinically most significant DRP-risk predicting factors identified by the geriatrician. Results: The geriatrician reviewed 45 clients' medications using all 3 methods. Based on PN-completed DRP-RAT and medication list, 93% (42/45) of the clients were classified as "at-risk patients." Two other review methods resulted in 45/45 (100%) "at-risk patients." Symptoms suggestive of adverse drug reactions were the most significant risk predicting factors. Small sample size limits the generalizability of the results. Conclusions: The PN-completed DRP-RAT was able to provide clinically important timely patient information for clinical decision making. DRP-RAT could make it possible to more effectively involve PNs in medication risk management among older HC clients.

Downloadable publication

This is an electronic reprint of the original article.
This reprint may differ from the original in pagination and typographic detail. Please cite the original version.




Last updated on 2019-20-07 at 08:05