title: Drug-Related-Problem Outcomes and Program Satisfaction from a Comprehensive Brown Bag Medication Review.
abstract: OBJECTIVE
  To classify and quantify drug-related problems (DRPs), determine acceptance of DRP recommendations, and assess medication review satisfaction.
  
  
  METHODS
  Comprehensive brown bag medication reviews.
  
  
  METHODS
  Six senior centers and three senior high-rises.
  
  
  METHODS
  Individuals aged 60 and older (mean age 75.9 ± 8.5) taking five or more medications (n = 85).
  
  
  METHODS
  Two investigators independently classified DRPs using modified Pharmaceutical Care Network Europe classification scheme and severity of medication error and value of service scales. Two other investigators adjudicated classification differences. Satisfaction surveys were administered immediately and 3 months after review. A DRP recommendation implementation survey was completed at least 3 months after the review.
  
  
  RESULTS
  Participants had a mean of 4.3 ± 2.8 DRPs (range 0-10). DRPs were classified as adverse reactions (30%), treatment effectiveness (28%), treatment costs (13%), information need (8%), and other (21%). Causes included drug selection (40%), wrong dosage (23%), participant problems (e.g., adherence, lack of medication knowledge, 16%), drug use process problems (12%), drug formulation (0.5%), treatment duration (0.5%), and other (7%). Interventions required drug changes (44%), prescriber input (37%), individual counseling (18%), or other (1%). DRP severities were significant (59%) or minor (35%). Participants expressed satisfaction with the program because they were able to ask questions, trusted the answers, and knew more about their medications. After 3 months, they had implemented 63% of the DRP recommendations.
  
  
  CONCLUSIONS
  Older adults found the medication review helpful and implemented 63% of the DRP recommendations.
authors: Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan.
authors: Mary Beth
authors: MB
authors: O'Connell
authors: School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada.
authors: Feng
authors: F
authors: Chang
authors: Pharmacy Department, Bronson Methodist Hospital, Kalamazoo, Michigan.
authors: Ashley
authors: A
authors: Tocco
authors: Veteran Affairs Healthcare System, Ann Arbor, Michigan.
authors: Megan E
authors: ME
authors: Mills
authors: Henry Ford Health System and Health Alliance Plan Ambulatory Clinical Pharmacy Programs, Grosse Pointe, Michigan.
authors: Jamie M
authors: JM
authors: Hwang
authors: Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan.|Rosa Parks Wellness Institute for Senior Health and Harper University Hospital, Detroit Medical Center, Detroit, Michigan.
authors: Candice L
authors: CL
authors: Garwood
authors: Henry Ford Health System and Health Alliance Plan Ambulatory Clinical Pharmacy Programs, Novi, Michigan.
authors: Hanan S
authors: HS
authors: Khreizat
authors: School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada.|Valley Plaza Pharmasave, Hanmer, Ontario, Canada.
authors: Nishi S
authors: NS
authors: Gupta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015397:Program Evaluation
keywords: drug-related problems; elderly; medication therapy management; pharmacists; pharmacy services