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 .
Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness
Background The magnitude of safety risks related to medications of the older adults has been evidence d by numerous studies , but less is known of how to manage and prevent these risks in different health care setting s. The aim of this study was to coordinate re sources for prospect i ve medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure . Methods Health care units involved in the study are from primary care in Lohja , Southern Finl and : home care ( 191 consented clients ) , the public healthcare center , and a private community pharmacy .  System based risk management theory and action research method was applied to construct the collaborative procedure utilizing each profession ’s existing re sources in medication risk management of older home care clients . An inventory of clinical measures in usual clinical practice and systematic review of rigorous study design s was utilized in effectiveness study design . Discussion The new coordinated medication management model ( CoMM ) has the following 5 stages : 1 ) practical nurses are trained to identify clinical ly significant drug-related problems ( DRPs ) during home visits and report those to the clinical pharmacist . Clinical pharmacist prepares the cases for 2 ) an interprofessional triage meeting ( 50–70 cases/meeting of 2 h ) where decisions are made on further action , e.g. , more detailed medication review s , 3 ) community pharmacists conduct necessary medication review s and each patients ’ physician makes final decisions on medication changes needed . The final stages concern 4 ) implementation and 5 ) follow-up of medication changes . R and omized controlled trial ( RCT ) was developed to demonstrate the effectiveness of the procedure . The developed procedure is feasible for screening and review ing medications of a high number of older home care clients to identify clients with severe DRPs and provide interventions to solve them utilizing existing primary care re sources .Trial registration The study is registered in the Clinical Trials.gov ( NCT02545257 ) . Registration date September 9 2015
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 .