Electronic tools to facilitate medication review in nursing homes: a pilot study.

Abstract

Objectives: Medication reviews (MRs) in nursing homes (NHs) are valuable but time-consuming. Electronic screening tools can assist community pharmacists by detecting potential drug-related problems (pDRPs). This study aimed to evaluate the implementation of electronic tools (GheOP³S-tool and EBMeDS®CMR) to facilitate MR in NH residents and to explore the overall clinical and economic impact of this MR process.

Methods: A pilot study was conducted in one NH (January-July 2024). For each included resident (life expectancy of ≥3 months, excluding short-stays and general practitioner (GP) refusals), a 3-step MR was performed: 1) medication record analysis by a pharmacist using GheOP³S-tool and EBMeDS®CMR, and additional implicit screening, 2) interdisciplinary meeting (with pharmacist, GP, nurse) to discuss pDRPs and interventions, and 3) 3-month follow-up. Primary outcomes included the number, type, and resolution rate of pDRPs per screening method. Secondary outcomes were changes in medication use (number, fall risk-increasing drugs (FRIDs), Drug Burden Index (DBI)), and medication costs.

Results: Fifty-four residents were included (mean age 84.7 ± 8.9 years, 66.7% female). The electronic tools detected 508 pDRPs: 41.7% only by GheOP³S-tool, 29.5% only by EBMeDS®CMR, and 28.7% by both. The pharmacist appended 252 pDRPs. Of the 603 recommendations formulated, 48.4% were accepted and 37.5% implemented. The overall resolution rate was 40.1%. At follow-up, significant reductions were observed in number of medications, FRIDs, DBI, and medication costs.

Conclusion: GheOP³S-tool and EBMeDS®CMR detected a considerable proportion of complementary pDRPs. A substantial part of pDRPs was appended by the pharmacist, highlighting the importance of combining explicit and implicit screening.