title: Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care.
abstract: BACKGROUND
  regular medication review has been recommended for those over 75 and those on multiple drug therapy. Pharmacists are a potential source of assistance in reviewing medication. Evidence of the benefits of this process is needed.
  
  
  OBJECTIVE
  to study the effect of medication review led by a pharmacist on resolution of pharmaceutical care issues, medicine costs, use of health and social services and health-related quality of life.
  
  
  METHODS
  randomized, controlled trial.
  
  
  METHODS
  general medical practices in the Grampian region of Scotland.
  
  
  METHODS
  patients aged at least 65 years, with at least two chronic disease states who were taking at least four prescribed medicines regularly.
  
  
  METHODS
  pharmacists reviewed the drug therapy of 332 patients, using information obtained from the practice computer, medical records and patient interviews. In 168 patients, a pharmaceutical care plan was then drawn up and implemented. The 164 control patients continued to receive normal care. All outcome measures were assessed at baseline and after 3 months.
  
  
  RESULTS
  all patients had at least two pharmaceutical care issues at baseline. Half of these were identified from the prescription record, the rest from notes and patient interview. Of all the issues, 21% were resolved by information found in notes and 8.5% by patient interview. General practitioners agreed with 96% of all care issues documented on the care plans in the intervention group. At the time of follow-up, 70% of the remaining care issues had been resolved in the intervention group, while only 14% had been resolved in the control group. There were no changes in medicine costs or health-related quality of life in either group. There were small increases in contacts with health-care professionals and slightly fewer hospital admissions among the intervention group than the control group.
  
  
  CONCLUSIONS
  pharmacist-led medication review has the capacity to identify and resolve pharmaceutical care issues and may have some impact on the use of other health services.
authors.affiliation: School of Pharmacy, The Robert Gordon University, Aberdeen, UK. Albyn Medical Practice, Aberdeen, UK. jkrska@collpharm.org.uk
authors.forename: J
authors.initials: J
authors.lastname: Krska
authors.forename: J A
authors.initials: JA
authors.lastname: Cromarty
authors.forename: F
authors.initials: F
authors.lastname: Arris
authors.forename: D
authors.initials: D
authors.lastname: Jamieson
authors.forename: D
authors.initials: D
authors.lastname: Hansford
authors.forename: P R
authors.initials: PR
authors.lastname: Duffus
authors.forename: G
authors.initials: G
authors.lastname: Downie
authors.forename: D G
authors.initials: DG
authors.lastname: Seymour
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures; D006299:Health Services for the Aged; D006304:Health Status; D006801:Humans; D008297:Male; D010593:Pharmaceutical Services / Q000639:trends*; D010595:Pharmacists / Q000639:trends*; D011788:Quality of Life; D012947:Social Work