Impact of the Lund Integrated Medicines Management (LIMM) model on medication appropriateness and drug-related hospital revisits.
2011 (English)In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 67, no 7, 741-752 p.Article in journal (Refereed) Published
To examine the impact of systematic medication reconciliations when admitted to hospital, and medication review while in hospital, on the number of inappropriate medications and unscheduled drug-related hospital revisits in elderly patients.
A prospective, controlled study in 210 patients, aged 65 years or older, who were admitted to one of three internal medicine wards at a University Hospital in Sweden. Patients received either standard care or care according to the Lund Integrated Medicines Management (LIMM) model. A multi-professional team, including a clinical pharmacist, provided medication reconciliations on admission and medication reviews during the hospital stay for the LIMM group. Blinded reviewers evaluated the appropriateness of the prescribing (using the Medication Appropriateness Index) on admission and discharge, and assessed the probability that a drug-related problem was the reason for any patient readmitted to hospital or visiting the emergency department within three months of discharge (using WHO causality criteria).
There was a greater decrease in the number of inappropriate drugs in the intervention group than in the control group for both the intention-to-treat population (51% [95% CI 43-58%] versus 39% [95% CI 30-48%], p=0.0446) and the per-protocol population (60% [95% CI 51-67%] versus 44% [95% CI 34-52 %], p=0.0106). There were 6 revisits to hospital in the intervention group which were judged as ‘possibly, probably or certainly drug-related’, compared with 12 in the control group (p=0.0469).
In this study, medication reconciliation and reviews provided by a clinical pharmacist in a multi-professional team significantly reduced the number of inappropriate drugs and unscheduled drug-related hospital revisits for elderly patients.
Place, publisher, year, edition, pages
2011. Vol. 67, no 7, 741-752 p.
Clinical pharmacy services, Medication Appropriateness Index, Medication review, Medication reconciliation, Drug-related problems, Inpatients
Klinisk farmaci, Läkemedelsgenomgång, Läkemedelsavstämning, Läkemedelsrelaterade problem, Slutenvård, Olämpliga läkemedel, Återinläggning
Research subject Natural Science, Biomedical Sciences
IdentifiersURN: urn:nbn:se:lnu:diva-10170DOI: 10.1007/s00228-010-0982-3OAI: oai:DiVA.org:lnu-10170DiVA: diva2:388928