Physicians’ acceptance of pharmaceutical medication reviews in an institution for the Elderly Buchmann S 1, Krähenbühl J.M 2, Nyffeler R 3, Buchmann M 1, Bugnon O 2 1 Tête-Noire Pharmacy, Romont, Switzerland; 2 Universitary Medical Outpatient Clinic, Lausanne, Switzerland; 3 Nursing Home of Billens, Switzerland

Objective and design Objective : Improve patient safety and drug efficiency in a nursing home, by developing a pharmaceutical medication review service Design : Prospective evaluation of physicians’ acceptance and of implementation of accepted interventions between February 2002 and January 2003 Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland

Design Nursing home of Billens 6 physicians 77 patients 142 interventions Accepted Discussed Refused Accepted Check of the degree of implementation 6 months after the review Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland

Results Repartition of the interventions 34%Interaction 30%Inadequate treatment 18%Proposal for a laboratory monitoring 9%Adverse event 5%Inadequate medicine’s strength 4%Inadequate administration’s frequency 30% of the interventions were about the cardiovascular system and 23% were about the central nervous system Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland

Results Accepted pharmaceutical interventions Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland

Results Clinical interest for physicians Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland

Results Implementation 6 months after the review 22 accepted interventions concerning Treatment Medicine’s strength Administration’s frequency 6 months after the review, check in the patients’ Kardex ® 82 % of accepted interventions were effectively applied Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland

Conclusions This pharmaceutical medication review service Improved patients’ safety and drug efficiency Was frequently accepted and applied by physicians Enabled interdisciplinary work allowing an improvement in the quality of care Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland

Future  Determine the pharmaco-economical added value of the service  Evaluate the opportunity to disseminate it to other institutions for the Elderly Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland

Special thanks For advices and support during this work:  Dr med. B. Lanier, Nursing home of Billens, Switzerland  Dr med. R. Brun, Nursing home of Billens, Switzerland  Dr med. C. Huguenot, Nursing home of Billens, Switzerland  Dr med. N. Gueissaz, Nursing home of Billens, Switzerland  Dr med. J-L. Rime, Nursing home of Billens, Switzerland  All the nurses of the Nursing home of Billens, Switzerland For the realization of this presentation:  M Ruggli, Swiss Pharmaceutical Society, Bern, Switzerland Buchmann Sophie, Tête-Noire Pharmacy, Romont, Switzerland