This review will provide an exhaustive view of medication management models that could be effective for polymedicated , home-dwelling older adults and will allow us to analyze their impact on managing and preventing MRPs .
BACKGROUND Older adults with multiple chronic diseases commonly require complex medication regimes .
When combined with frailty , cognitive impairment , and changing pharmacological prescriptions , older adults ' polymedication regimes increase the risk of medication-related problems ( MRPs ) and hospitalization .
Effective , well-organized medication management could avoid MRPs and their clinical outcomes .
OBJECTIVE Identify medication management models and analyze their impact on managing and preventing MRPs for polymedicated , home-dwelling older adults .
A model for improving medication use in home health care patients.
OBJECTIVES ( 1 ) To develop a model for the identification and resolution of problems associated with suboptimal medication use in elderly patients receiving home health care ; ( 2 ) To select the most important identifiable problems and develop structured procedures for their resolution . DESIGN Expert panel review , problem selection , and development of a problem resolution model and guidelines . SETTING Home health care . PARTICIPANTS A panel with expertise in home health nursing , pharmacy , clinical pharmacology , gerontology , pharmacoepidemiology , and health services research . INTERVENTIONS A list of potential problems associated with the most frequently used classes of drugs was compiled for review by the panel . Problems that were controversial or that could not be identified in the home care setting were excluded . Panel members individually ranked the remainder . Detailed procedures for identification and resolution of the 15 top-ranking problems were developed . MAIN OUTCOME MEASURES Not applicable . RESULTS Potential medication problems were defined by both drug use and symptoms or clinical signs associated with specific adverse effects , to ensure that clinical ly relevant problems would be identified . The model developed for problem assessment and resolution was centered on the drug utilization review ( DUR ) coordinator and the attending home health nurse . Following guidelines developed by the panel , the DUR coordinator advises the home health nurse about identified problems and how to resolve them . One of these practitioners , usually the nurse , then contacts the attending physician to explain their concerns , offer potential solutions , and request instructions . CONCLUSION A potentially useful model for the identification and resolution of medication problems in the home health care setting was developed . This model is currently being evaluated in a r and omized controlled trial
This review will provide an exhaustive view of medication management models that could be effective for polymedicated , home-dwelling older adults and will allow us to analyze their impact on managing and preventing MRPs .
BACKGROUND Older adults with multiple chronic diseases commonly require complex medication regimes .
When combined with frailty , cognitive impairment , and changing pharmacological prescriptions , older adults ' polymedication regimes increase the risk of medication-related problems ( MRPs ) and hospitalization .
Effective , well-organized medication management could avoid MRPs and their clinical outcomes .
OBJECTIVE Identify medication management models and analyze their impact on managing and preventing MRPs for polymedicated , home-dwelling older adults .