Pharmacists’ Recommendations to Reduce Drug Therapy Problems in Nursing Home Residents
Main Article Content
Keywords
drug therapy problem, elderly, pharmacists’ recommendation
Abstract
Objective: Comprehensive Medication Management Services (CMM) are clinical services based on pharmaceutical care, and represents a patient-centred approach in which the pharmacist takes the responsibility for the patient’s needs. This study aimed to describe drug therapy problems among nursing home residents, identified through pharmacists’ provision of CMM, and assess physicians’ acceptance of pharmacists’ recommendations. Methods: A cross-sectional observational study was conducted from February 2018 to January 2019 in a nursing home in Croatia. Utilizing the Pharmacotherapy Workup method by Cipolle et al., pharmacists assessed and classified DTPs related to indication, effectiveness, safety, and adherence. Recommendation included medication discontinuation, dose adjustments and patient education. Results: Sixty residents were included in the study. Median age was 79.9 (IQR 66.1 – 96.7) years. On average, residents used 7 (IQR 2–16) medications and had 5 (IQR 1–12) comorbidities. In total, 141 DTPs were identified (4.3 ± SD2.35 per resident). The most prevalent DTP was” additional drug therapy needed” (n =55; 39%), falling into the effectiveness category. The pharmacists suggested 133 modifications for the identified DTPs. Physicians accepted a total number of 112 recommendations (84.21%). Conclusion: The high prevalence of DTPs identified and substantial acceptance of pharmacists’ recommendations strongly suggests the need to incorporate CMM services within long-term care facilities with intent to improve quality of care. The results demonstrate that pharmacists are pivotal in optimizing therapeutic outcomes through effective medication management.
References
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from: https://www.who.int/news-room/fact-sheets/detail/dementia
2. Age Platform Europe. 2021 EU Long-term care report: A highly useful analysis to inform care policymaking [Internet]. Brussels:
Age Platform Europe; c2022 [cited 2022 Nov 23]. Available from: https://www.age-platform.eu/policy-work/news/2021-eulong-
term-care-report-highly-useful-analysis-inform-care-policymaking
3. Eurostat. Ageing Europe — Looking at the lives of older people in the EU — 2020 edition [Internet]. Luxembourg: European
Commission - Eurostat; 2020 [cited 2022 Jul 20]. Available from: https://ec.europa.eu/eurostat/documents/3217494/11478263/
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dzs.hr/.
5. Jokanovic N, Tan EC, Dooley MJ, Kirkpatrick CM, Bell JS. Prevalence and factors associated with polypharmacy in long-term
care facilities: a systematic review. J Am Med Dir Assoc. 2015 Jun 1;16(6):535.e1–535.e12.
6. Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother. 2007 Dec;5(4):345-351.
7. Choo J, Hutchinson A, Bucknall T. Nurses’ role in medication safety. J Nurs Manag. 2010 Oct 1;18(7):853–61.
8. Kowalski SL, Anthony M. CE: Nursing’s evolving role in patient safety. Am J Nurs. 2017 Feb;117(2):34–48.
9. Smeulers M, Lucas C, Vermeulen H. Effectiveness of different nursing handover styles for ensuring continuity of information in
hospitalised patients. Cochrane Database Syst Rev. 2014 Jun 24;2014(6).
10. Berland A, Bentsen SB. Medication errors in home care: a qualitative focus group study. J Clin Nurs. 2017 Nov;26(21–22):3734–
41.
11. Bystedt M, Eriksson M, Wilde-Larsson B. Delegation within municipal health care. J Nurs Manag. 2011 May;19(4):534–41.
12. Gransjön Craftman A, Sundell Y, Westerbotn M. Medicine management in municipal home care: delegating, administrating
and receiving. Scand J Caring Sci. 2015 Sep;29(3):477–85.
13. Craftman ÅG, Grundberg Å, Westerbotn M. Experiences of home care assistants providing social care to older people: A
context in transition. Int J Older People Nurs. 2018 Dec 1;13(4).
14. American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria®
for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674–694.
15. Castle NG, Ferguson JC. What is nursing home quality and how is it measured? Gerontologist. 2010 Aug;50(4):426–442.
16. Christensen D, Trygstad T, Sullivan R, Garmise J, Wegner SE. A pharmacy management recommendation for optimising drug
therapy for nursing home patients. Am J Geriatr Pharmacother. 2004 Dec;2(4):248–56.
17. Rao D, Gilbert A, Strand LM, Cipolle RJ. Drug therapy problems found in ambulatory patient populations in Minnesota and
South Australia. Pharm World Sci. 2007 Dec;29(6):647–54.
18. Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice. The patient-centered approach to medication management
services. 3rd ed. New York: McGraw-Hill; 2012.
19. Strand LM, Cipolle RJ, Morley PC, Frakes MJ. The impact of pharmaceutical care practice on the practitioner and the patient in
the ambulatory practice setting: twenty-five years of experience. Curr Pharm Des. 2005 Mar;10(31):3987–4001.
20. Cipolle CL, Cipolle RJ, Strand LM. Consistent standards in medication use: the need to care for patients from research to
practice. J Am Pharm Assoc (1996). 2006 May-Jun;46(3):387-391.
21. Kassam R, Farris KB, Burback L, Cox CE, Cave A. Pharmaceutical care research and education project: pharmacists’
recommendations. J Am Pharm Assoc (Wash). 2001 May-Jun;41(3):401–10.
22. Levenson SA, Saffel D. The consultant pharmacist and the physician in the nursing home: roles, relationships, and a recipe for
success. Consult Pharm. 2007 Jan;22(1):71–82.
23. Sluggett JK, Chen EY, Ilomäki J, Corlis M, van Emden J, Hogan M, et al. Reducing the burden of complex medication regimens:
simplification of medications prescribed to long-term care residents (SIMPLER) cluster randomized controlled trial. J Am Med
Dir Assoc. 2020 Aug;21(8):1114–1120.e4.
24. Sluggett JK, Hopkins RE, Chen EY, Ilomäki J, Corlis M, van Emden J, et al. Impact of medication regimen simplification on
medication administration times and health outcomes in residential aged care: 12-month follow-up of the SIMPLER randomized
controlled trial. J Clin Med. 2020 Apr;9(4):1053.
25. Zaal RJ, den Haak EW, Elrozy R, Andrinopoulou ER, van Gelder T, Vulto AG, et al. Physicians’ acceptance of pharmacists’
recommendations in daily hospital practice. Int J Clin Pharm. 2020 Jun;42(3):141–9.
26. Chen EY, Wang KN, Sluggett JK, Ilomäki J, Hilmer SN, Corlis M, et al. Process, impact and outcomes of medication review in
Australian residential aged care facilities: a systematic review. Australas J Ageing. 2019 Sep;38(Suppl 2):9–25.
27. Alves Da Costa F, Silvestre L, Periquito C, Carneiro C, Oliveira P, Fernandes AI, et al. Drug-related problems identified in a sample
of Portuguese institutionalised elderly patients and pharmacists’ recommendations to improve safety and effectiveness of
medicines. Drugs Aging. 2019 Jun;36(6):497-506.
28. Fehir Šola K, Mucalo I, Brajković A, Jukić I, Verbanac D, Knežević SV. Drug therapy problems identified among older adults
placed in a nursing home: the Croatian experience. J Int Med Res. 2020 Jun;48(6):1–15.
29. Moecker R, Weissenborn M, Klingenberg A, Herda C, Apfelbacher C. Task sharing in an interprofessional medication management
program – a survey of general practitioners and community pharmacists. BMC Health Serv Res. 2022 Aug;22(1):1005.
30. Kaiser L, Conrad S, Neugebauer EAM, Ziegler S, Briegel S. Interprofessional collaboration and patient-reported outcomes in
inpatient care: a systematic review. Syst Rev. 2022 Jun;11(1):169.
31. Fog AF, Mdala I, Engedal K, Straand J. Variation between nursing homes in drug use and in drug-related problems. BMC Geriatr.
2020 Sep;20(1):1–9.
32. Finkers F, Maring JG, Boersma F, Taxis K. A study of medication reviews to identify drug-related problems of polypharmacy
patients in the Dutch nursing home setting. J Clin Pharm Ther. 2007 Oct;32(5):469–76.
33. Díez R, Cadenas R, Susperregui J, Sahagún AM, Fernández N, García JJ, et al. Drug-related problems and polypharmacy in
nursing home residents: a cross-sectional study. Int J Environ Res Public Health. 2022 Apr;19(7):4313. 34. Erzkamp S, Köberlein-Neu J, Rose O. An algorithm for comprehensive medication management in nursing homes: results of the
AMBER project. Drug Saf. 2021 Mar;44(3):313–25.
35. Douglas N, Mays N, Al-Haboubi M, Holmes R, Dixon J. Observations of community-based multidisciplinary team meetings in
health and social care for older people with long-term conditions in England. BMC Health Serv Res. 2022 Aug;22(1):758.
36. Individualised CARE for Older Persons with Complex Chronic Conditions at Home and in Nursing Homes | I-CARE4OLD Project
[Internet]. European Commission. Available from: https://cordis.europa.eu/project/id/965341. Accessed 2022 Dec 5.
37. Lee SWH, Mak VSL, Tang YW. Pharmacist services in nursing homes: A systematic review and meta‐analysis. Br J Clin Pharmacol.
2019 Dec;85(12):2668–88
38. American College of Clinical Pharmacy. Comprehensive Medication Management in Team-Based Care.
39. Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, Hanlon JT. Appropriate Prescribing in Elderly People: How
Well Can It Be Measured and Optimised? Lancet. 2007;370:173–84.
40. Halvorsen KH, Stadeløkken T, Garcia BH. A Stepwise Pharmacist-Led Medication Review Service in Interdisciplinary Teams in
Rural Nursing Homes. Pharm (Basel). 2019;7(4):148.
41. Zucker I, Prendergast BJ. Sex differences in pharmacokinetics predict adverse drug reactions in women. Biol Sex Differ.
2020;11(1):32. doi: 10.1186/s13293-020-00308-5.
42. Abad-Díez JM, Calderón-Larrañaga A, Poncel-Falcó A, et al. Age and gender differences in the prevalence and patterns of
multimorbidity in the older population. BMC Geriatr. 2014;14:75. doi: 10.1186/1471-2318-14-75.
43. Shepherd J, Gurney S, Harnish P, Patel. Shared decision making and personalised care support planning: Pillars of integrated
care for older people. Clin Integr Care. 2022;12:100097. doi: 10.1016/j.intcar.2022.100097.
44. Balsom C, Pittman N, King R, Kelly D. Impact of a pharmacist-administered deprescribing intervention on nursing home
residents: A randomised controlled trial. Int J Clin Pharm. 2020;42(4):1153–67.
45. Kua CH, Mak VSL, Lee SW. Health Outcomes of Deprescribing Interventions Among Older Residents in Nursing Homes: A
Systematic Review and Meta-analysis. J Am Med Dir Assoc. 2019;20(3):362-72.e11.
46. Bužančić I, Dragović P, Pejaković TI, Markulin L, Ortner-Hadžiabdić M. Exploring Patients’ Attitudes Toward Deprescribing
and Their Perception of Pharmacist Involvement in a European Country: A Cross-Sectional Study. Patient Prefer Adherence.
2021;15:2197–208.
47. Lundby C, Glans P, Simonsen T, et al. Attitudes towards deprescribing: The perspectives of geriatric patients and nursing home
residents. J Am Geriatr Soc. 2021;69(6):1508–18.
48. Graabæk T, Lundby C, Ryg J, Søndergaard J, Pottegård A, Nielsen DS. ‘I simply don’t know, because I don’t know which drugs I
get’: Perspectives on deprescribing among older adults with limited life expectancy and their relatives. Basic Clin Pharmacol
Toxicol. 2021;128(1):115–27.
49. Ferries E, Dye JT, Hall B, et al. Comparison of Medication Therapy Management Services and Their Effects on Health Care
Utilization and Medication Adherence. J Manag Care Spec Pharm. 2019;25(6).
50. Ali S, Salahudeen MS, Bereznicki LRE, Curtain CM. Pharmacist-led interventions to reduce adverse drug events in older people
living in residential aged care facilities: A systematic review. Br J Clin Pharmacol. 2021;87(10):3672–89.
51. Spinewine A, Evrard P, Hughes C. Interventions to optimise medication use in nursing homes: A narrative review. Eur Geriatr
Med. 2021;12(3):551–67.
52. Bedouch P, Sylvoz N, Charpiat B, Juste M, Roubille R, Rose FX, et al. Trends in pharmacists’ medication order review in French
hospitals from 2006 to 2009: Analysis of pharmacists’ interventions from the Act-IP© website observatory. J Clin Pharm Ther.
2015;40(1):32–40.
53. Zaal RJ, den Haak EW, Andrinopoulou ER, van Gelder T, Vulto AG, van den Bemt PMLA. Physicians’ acceptance of pharmacists’
interventions in daily hospital practice. Int J Clin Pharm. 2020;42(1):141–9.
54. Lee SWH, Mak VSL, Tang YW, et al. Pharmacist services in nursing homes: A systematic review and meta‐analysis. Br J Clin
Pharmacol. 2019;85(12):2668–88.
55. Hashimoto R, Fujii K, Shimoji S, et al. Study of pharmacist interventions in polypharmacy among older patients: Nonrandomised,
controlled trial. Geriatr Gerontol Int. 2020;20(3):229–37.
56. McDerby NC, Kosari S, Bail KS, et al. The role of a residential aged care pharmacist: Findings from a pilot study. Australas J
Ageing. 2020;39(3)–71.
57. McDerby N, Kosari S, Bail K, et al. The effect of a residential care pharmacist on medication administration practices in aged
care: A controlled trial. J Clin Pharm Ther. 2019;44(4):595–602.
from: https://www.who.int/news-room/fact-sheets/detail/dementia
2. Age Platform Europe. 2021 EU Long-term care report: A highly useful analysis to inform care policymaking [Internet]. Brussels:
Age Platform Europe; c2022 [cited 2022 Nov 23]. Available from: https://www.age-platform.eu/policy-work/news/2021-eulong-
term-care-report-highly-useful-analysis-inform-care-policymaking
3. Eurostat. Ageing Europe — Looking at the lives of older people in the EU — 2020 edition [Internet]. Luxembourg: European
Commission - Eurostat; 2020 [cited 2022 Jul 20]. Available from: https://ec.europa.eu/eurostat/documents/3217494/11478263/
KS-02-20-655-EN-N.pdf 4. Croatian Bureau of Statistics [Internet]. Zagreb: Croatian Bureau of Statistics; [cited 2024 Jul 7]. Available from: http://www.
dzs.hr/.
5. Jokanovic N, Tan EC, Dooley MJ, Kirkpatrick CM, Bell JS. Prevalence and factors associated with polypharmacy in long-term
care facilities: a systematic review. J Am Med Dir Assoc. 2015 Jun 1;16(6):535.e1–535.e12.
6. Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother. 2007 Dec;5(4):345-351.
7. Choo J, Hutchinson A, Bucknall T. Nurses’ role in medication safety. J Nurs Manag. 2010 Oct 1;18(7):853–61.
8. Kowalski SL, Anthony M. CE: Nursing’s evolving role in patient safety. Am J Nurs. 2017 Feb;117(2):34–48.
9. Smeulers M, Lucas C, Vermeulen H. Effectiveness of different nursing handover styles for ensuring continuity of information in
hospitalised patients. Cochrane Database Syst Rev. 2014 Jun 24;2014(6).
10. Berland A, Bentsen SB. Medication errors in home care: a qualitative focus group study. J Clin Nurs. 2017 Nov;26(21–22):3734–
41.
11. Bystedt M, Eriksson M, Wilde-Larsson B. Delegation within municipal health care. J Nurs Manag. 2011 May;19(4):534–41.
12. Gransjön Craftman A, Sundell Y, Westerbotn M. Medicine management in municipal home care: delegating, administrating
and receiving. Scand J Caring Sci. 2015 Sep;29(3):477–85.
13. Craftman ÅG, Grundberg Å, Westerbotn M. Experiences of home care assistants providing social care to older people: A
context in transition. Int J Older People Nurs. 2018 Dec 1;13(4).
14. American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria®
for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674–694.
15. Castle NG, Ferguson JC. What is nursing home quality and how is it measured? Gerontologist. 2010 Aug;50(4):426–442.
16. Christensen D, Trygstad T, Sullivan R, Garmise J, Wegner SE. A pharmacy management recommendation for optimising drug
therapy for nursing home patients. Am J Geriatr Pharmacother. 2004 Dec;2(4):248–56.
17. Rao D, Gilbert A, Strand LM, Cipolle RJ. Drug therapy problems found in ambulatory patient populations in Minnesota and
South Australia. Pharm World Sci. 2007 Dec;29(6):647–54.
18. Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice. The patient-centered approach to medication management
services. 3rd ed. New York: McGraw-Hill; 2012.
19. Strand LM, Cipolle RJ, Morley PC, Frakes MJ. The impact of pharmaceutical care practice on the practitioner and the patient in
the ambulatory practice setting: twenty-five years of experience. Curr Pharm Des. 2005 Mar;10(31):3987–4001.
20. Cipolle CL, Cipolle RJ, Strand LM. Consistent standards in medication use: the need to care for patients from research to
practice. J Am Pharm Assoc (1996). 2006 May-Jun;46(3):387-391.
21. Kassam R, Farris KB, Burback L, Cox CE, Cave A. Pharmaceutical care research and education project: pharmacists’
recommendations. J Am Pharm Assoc (Wash). 2001 May-Jun;41(3):401–10.
22. Levenson SA, Saffel D. The consultant pharmacist and the physician in the nursing home: roles, relationships, and a recipe for
success. Consult Pharm. 2007 Jan;22(1):71–82.
23. Sluggett JK, Chen EY, Ilomäki J, Corlis M, van Emden J, Hogan M, et al. Reducing the burden of complex medication regimens:
simplification of medications prescribed to long-term care residents (SIMPLER) cluster randomized controlled trial. J Am Med
Dir Assoc. 2020 Aug;21(8):1114–1120.e4.
24. Sluggett JK, Hopkins RE, Chen EY, Ilomäki J, Corlis M, van Emden J, et al. Impact of medication regimen simplification on
medication administration times and health outcomes in residential aged care: 12-month follow-up of the SIMPLER randomized
controlled trial. J Clin Med. 2020 Apr;9(4):1053.
25. Zaal RJ, den Haak EW, Elrozy R, Andrinopoulou ER, van Gelder T, Vulto AG, et al. Physicians’ acceptance of pharmacists’
recommendations in daily hospital practice. Int J Clin Pharm. 2020 Jun;42(3):141–9.
26. Chen EY, Wang KN, Sluggett JK, Ilomäki J, Hilmer SN, Corlis M, et al. Process, impact and outcomes of medication review in
Australian residential aged care facilities: a systematic review. Australas J Ageing. 2019 Sep;38(Suppl 2):9–25.
27. Alves Da Costa F, Silvestre L, Periquito C, Carneiro C, Oliveira P, Fernandes AI, et al. Drug-related problems identified in a sample
of Portuguese institutionalised elderly patients and pharmacists’ recommendations to improve safety and effectiveness of
medicines. Drugs Aging. 2019 Jun;36(6):497-506.
28. Fehir Šola K, Mucalo I, Brajković A, Jukić I, Verbanac D, Knežević SV. Drug therapy problems identified among older adults
placed in a nursing home: the Croatian experience. J Int Med Res. 2020 Jun;48(6):1–15.
29. Moecker R, Weissenborn M, Klingenberg A, Herda C, Apfelbacher C. Task sharing in an interprofessional medication management
program – a survey of general practitioners and community pharmacists. BMC Health Serv Res. 2022 Aug;22(1):1005.
30. Kaiser L, Conrad S, Neugebauer EAM, Ziegler S, Briegel S. Interprofessional collaboration and patient-reported outcomes in
inpatient care: a systematic review. Syst Rev. 2022 Jun;11(1):169.
31. Fog AF, Mdala I, Engedal K, Straand J. Variation between nursing homes in drug use and in drug-related problems. BMC Geriatr.
2020 Sep;20(1):1–9.
32. Finkers F, Maring JG, Boersma F, Taxis K. A study of medication reviews to identify drug-related problems of polypharmacy
patients in the Dutch nursing home setting. J Clin Pharm Ther. 2007 Oct;32(5):469–76.
33. Díez R, Cadenas R, Susperregui J, Sahagún AM, Fernández N, García JJ, et al. Drug-related problems and polypharmacy in
nursing home residents: a cross-sectional study. Int J Environ Res Public Health. 2022 Apr;19(7):4313. 34. Erzkamp S, Köberlein-Neu J, Rose O. An algorithm for comprehensive medication management in nursing homes: results of the
AMBER project. Drug Saf. 2021 Mar;44(3):313–25.
35. Douglas N, Mays N, Al-Haboubi M, Holmes R, Dixon J. Observations of community-based multidisciplinary team meetings in
health and social care for older people with long-term conditions in England. BMC Health Serv Res. 2022 Aug;22(1):758.
36. Individualised CARE for Older Persons with Complex Chronic Conditions at Home and in Nursing Homes | I-CARE4OLD Project
[Internet]. European Commission. Available from: https://cordis.europa.eu/project/id/965341. Accessed 2022 Dec 5.
37. Lee SWH, Mak VSL, Tang YW. Pharmacist services in nursing homes: A systematic review and meta‐analysis. Br J Clin Pharmacol.
2019 Dec;85(12):2668–88
38. American College of Clinical Pharmacy. Comprehensive Medication Management in Team-Based Care.
39. Spinewine A, Schmader KE, Barber N, Hughes C, Lapane KL, Swine C, Hanlon JT. Appropriate Prescribing in Elderly People: How
Well Can It Be Measured and Optimised? Lancet. 2007;370:173–84.
40. Halvorsen KH, Stadeløkken T, Garcia BH. A Stepwise Pharmacist-Led Medication Review Service in Interdisciplinary Teams in
Rural Nursing Homes. Pharm (Basel). 2019;7(4):148.
41. Zucker I, Prendergast BJ. Sex differences in pharmacokinetics predict adverse drug reactions in women. Biol Sex Differ.
2020;11(1):32. doi: 10.1186/s13293-020-00308-5.
42. Abad-Díez JM, Calderón-Larrañaga A, Poncel-Falcó A, et al. Age and gender differences in the prevalence and patterns of
multimorbidity in the older population. BMC Geriatr. 2014;14:75. doi: 10.1186/1471-2318-14-75.
43. Shepherd J, Gurney S, Harnish P, Patel. Shared decision making and personalised care support planning: Pillars of integrated
care for older people. Clin Integr Care. 2022;12:100097. doi: 10.1016/j.intcar.2022.100097.
44. Balsom C, Pittman N, King R, Kelly D. Impact of a pharmacist-administered deprescribing intervention on nursing home
residents: A randomised controlled trial. Int J Clin Pharm. 2020;42(4):1153–67.
45. Kua CH, Mak VSL, Lee SW. Health Outcomes of Deprescribing Interventions Among Older Residents in Nursing Homes: A
Systematic Review and Meta-analysis. J Am Med Dir Assoc. 2019;20(3):362-72.e11.
46. Bužančić I, Dragović P, Pejaković TI, Markulin L, Ortner-Hadžiabdić M. Exploring Patients’ Attitudes Toward Deprescribing
and Their Perception of Pharmacist Involvement in a European Country: A Cross-Sectional Study. Patient Prefer Adherence.
2021;15:2197–208.
47. Lundby C, Glans P, Simonsen T, et al. Attitudes towards deprescribing: The perspectives of geriatric patients and nursing home
residents. J Am Geriatr Soc. 2021;69(6):1508–18.
48. Graabæk T, Lundby C, Ryg J, Søndergaard J, Pottegård A, Nielsen DS. ‘I simply don’t know, because I don’t know which drugs I
get’: Perspectives on deprescribing among older adults with limited life expectancy and their relatives. Basic Clin Pharmacol
Toxicol. 2021;128(1):115–27.
49. Ferries E, Dye JT, Hall B, et al. Comparison of Medication Therapy Management Services and Their Effects on Health Care
Utilization and Medication Adherence. J Manag Care Spec Pharm. 2019;25(6).
50. Ali S, Salahudeen MS, Bereznicki LRE, Curtain CM. Pharmacist-led interventions to reduce adverse drug events in older people
living in residential aged care facilities: A systematic review. Br J Clin Pharmacol. 2021;87(10):3672–89.
51. Spinewine A, Evrard P, Hughes C. Interventions to optimise medication use in nursing homes: A narrative review. Eur Geriatr
Med. 2021;12(3):551–67.
52. Bedouch P, Sylvoz N, Charpiat B, Juste M, Roubille R, Rose FX, et al. Trends in pharmacists’ medication order review in French
hospitals from 2006 to 2009: Analysis of pharmacists’ interventions from the Act-IP© website observatory. J Clin Pharm Ther.
2015;40(1):32–40.
53. Zaal RJ, den Haak EW, Andrinopoulou ER, van Gelder T, Vulto AG, van den Bemt PMLA. Physicians’ acceptance of pharmacists’
interventions in daily hospital practice. Int J Clin Pharm. 2020;42(1):141–9.
54. Lee SWH, Mak VSL, Tang YW, et al. Pharmacist services in nursing homes: A systematic review and meta‐analysis. Br J Clin
Pharmacol. 2019;85(12):2668–88.
55. Hashimoto R, Fujii K, Shimoji S, et al. Study of pharmacist interventions in polypharmacy among older patients: Nonrandomised,
controlled trial. Geriatr Gerontol Int. 2020;20(3):229–37.
56. McDerby NC, Kosari S, Bail KS, et al. The role of a residential aged care pharmacist: Findings from a pilot study. Australas J
Ageing. 2020;39(3)–71.
57. McDerby N, Kosari S, Bail K, et al. The effect of a residential care pharmacist on medication administration practices in aged
care: A controlled trial. J Clin Pharm Ther. 2019;44(4):595–602.
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Pharmacists’ Recommendations to Reduce Drug Therapy Problems in Nursing Home Residents. Pharm Pract (Granada) [Internet]. 2025 May 26 [cited 2025 Jul. 16];23(2):1-10. Available from: https://pharmacypractice.org/index.php/pp/article/view/3196
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Pharmacists’ Recommendations to Reduce Drug Therapy Problems in Nursing Home Residents. Pharm Pract (Granada) [Internet]. 2025 May 26 [cited 2025 Jul. 16];23(2):1-10. Available from: https://pharmacypractice.org/index.php/pp/article/view/3196