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Published in: International Journal of Clinical Pharmacy 3/2021

01-06-2021 | Alzheimer's Disease | Research Article

Clinical, economic, and organizational impact of pharmacists’ interventions in a cognitive-behavioral unit in France

Authors: Teddy Novais, Fanny Maldonado, Maxime Grail, Pierre Krolak-Salmon, Christelle Mouchoux

Published in: International Journal of Clinical Pharmacy | Issue 3/2021

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Abstract

Objective Evaluate the clinical, economic, and organizational impact of pharmaceutical interventions performed during medication review in a cognitive-behavioral unit. Setting Study conducted in a cognitive-behavioral unit with retrospective data from January 2011 to june 2017. Methods This study was conducted from retrospective data of medication review in a cognitive-behavioral unit. During medication review, pharmacists identified relevant drug related problems lead to a pharmaceutical intervention which is submitted to the physician. All pharmaceutical interventions carried out from January 2011 to june 2017 were retrospectively analyzed to evaluate their clinical, economic and organizational impact using a multidimensional tool. Main outcome measure CLinical, Economic and Organizational impact using the CLEO tool. Results During the study period, 543 drug related problems and pharmaceutical interventions were recorded for patients hospitalized in the cognitive-behavioral unit (79.0 ± 9.5 years, 59% female). The most common types of drug related problems identified were ‘non conformity to guidelines / contra-indication’ (28.7%), ‘drug without indication’ (21.7%), and ‘improper administration’ (15.1%). The majority of pharmaceutical interventions were considered to have at least a clinical significant impact from the pharmacist’s perspective (74%). Regarding the economic and organizational dimensions, 55.2% of pharmaceutical interventions would decrease the costs of care and 35.9% of pharmaceutical interventions would be favorable on the quality of care process. Conclusions The present study shows that the pharmacist may detect a high number of drug related problems with significant clinical relevance during medication review in a cognitive-behavioral unit. Describing and identifying significant pharmaceutical interventions in cognitive-behavioral unit patients allow us to better understand and improve clinical practice in this population.
Literature
1.
go back to reference Strubel D. The specificities of care in cognitive-behavior units. Soins Gerontol. 2015;20(113):37–42.CrossRef Strubel D. The specificities of care in cognitive-behavior units. Soins Gerontol. 2015;20(113):37–42.CrossRef
2.
go back to reference Chan KY, Wang W, Wu JJ, Liu L, Theodoratou E, Car J, et al. Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990–2010: a systematic review and analysis. The Lancet. 2013;381(9882):2016–23.CrossRef Chan KY, Wang W, Wu JJ, Liu L, Theodoratou E, Car J, et al. Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990–2010: a systematic review and analysis. The Lancet. 2013;381(9882):2016–23.CrossRef
3.
go back to reference Gurwitz JH, Field TS, Harrold LR, Rothschild J, Debellis K, Seger AC, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA. 2003;289(9):1107–16.CrossRef Gurwitz JH, Field TS, Harrold LR, Rothschild J, Debellis K, Seger AC, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. JAMA. 2003;289(9):1107–16.CrossRef
4.
go back to reference Campbell NL, Boustani MA, Skopelja EN, Gao S, Unverzagt FW, Murray MD. Medication adherence in older adults with cognitive impairment: a systematic evidence-based review. Am J Geriatr Pharmacother. 2012;10(3):165–77.CrossRef Campbell NL, Boustani MA, Skopelja EN, Gao S, Unverzagt FW, Murray MD. Medication adherence in older adults with cognitive impairment: a systematic evidence-based review. Am J Geriatr Pharmacother. 2012;10(3):165–77.CrossRef
5.
go back to reference Pasqualetti G, Tognini S, Calsolaro V, Polini A, Monzani F. Potential drug-drug interactions in Alzheimer patients with behavioral symptoms. Clin Interv Aging. 2015;10:1457–66. PubMedPubMedCentral Pasqualetti G, Tognini S, Calsolaro V, Polini A, Monzani F. Potential drug-drug interactions in Alzheimer patients with behavioral symptoms. Clin Interv Aging. 2015;10:1457–66. PubMedPubMedCentral
6.
go back to reference Johnell K. Inappropriate drug use in people with cognitive impairment and dementia: a systematic review. Curr Clin Pharmacol. 2015;10(3):178–84.CrossRef Johnell K. Inappropriate drug use in people with cognitive impairment and dementia: a systematic review. Curr Clin Pharmacol. 2015;10(3):178–84.CrossRef
7.
go back to reference Sönnerstam E, Sjölander M, Lövheim H, Gustafsson M. Clinically relevant drug-drug interactions among elderly people with dementia. Eur J Clin Pharmacol. 2018;74(10):1351–60.CrossRef Sönnerstam E, Sjölander M, Lövheim H, Gustafsson M. Clinically relevant drug-drug interactions among elderly people with dementia. Eur J Clin Pharmacol. 2018;74(10):1351–60.CrossRef
8.
go back to reference Bonfiglio V, Umegaki H, Kuzuya M. Potentially inappropriate medications and polypharmacy: a study of older people with mild cognitive impairment and mild dementia. J Alzheimers Dis (JAD). 2019;71(3):889–97.CrossRef Bonfiglio V, Umegaki H, Kuzuya M. Potentially inappropriate medications and polypharmacy: a study of older people with mild cognitive impairment and mild dementia. J Alzheimers Dis (JAD). 2019;71(3):889–97.CrossRef
9.
go back to reference Griese-Mammen N, Hersberger KE, Messerli M, Leikola S, Horvat N, van Mil JWF, et al. PCNE definition of medication review: reaching agreement. Int J Clin Pharm. 2018;40(5):1199–208.CrossRef Griese-Mammen N, Hersberger KE, Messerli M, Leikola S, Horvat N, van Mil JWF, et al. PCNE definition of medication review: reaching agreement. Int J Clin Pharm. 2018;40(5):1199–208.CrossRef
10.
go back to reference van Mil JWF, Westerlund LOT, Hersberger KE, Schaefer MA. Drug-related problem classification systems. Ann Pharmacother. 2004;38(5):859–67.CrossRef van Mil JWF, Westerlund LOT, Hersberger KE, Schaefer MA. Drug-related problem classification systems. Ann Pharmacother. 2004;38(5):859–67.CrossRef
11.
go back to reference Dooley MJ, Allen KM, Doecke CJ, Galbraith KJ, Taylor GR, Bright J, et al. A prospective multicentre study of pharmacist initiated changes to drug therapy and patient management in acute care government funded hospitals. Br J Clin Pharmacol. 2004;57(4):513–21.CrossRef Dooley MJ, Allen KM, Doecke CJ, Galbraith KJ, Taylor GR, Bright J, et al. A prospective multicentre study of pharmacist initiated changes to drug therapy and patient management in acute care government funded hospitals. Br J Clin Pharmacol. 2004;57(4):513–21.CrossRef
12.
go back to reference Gillespie U, Alassaad A, Henrohn D, Garmo H, Hammarlund-Udenaes M, Toss H, et al. A comprehensive pharmacist intervention to reduce morbidity in patients 80 years or older: a randomized controlled trial. Arch Intern Med. 2009;169(9):894–900.CrossRef Gillespie U, Alassaad A, Henrohn D, Garmo H, Hammarlund-Udenaes M, Toss H, et al. A comprehensive pharmacist intervention to reduce morbidity in patients 80 years or older: a randomized controlled trial. Arch Intern Med. 2009;169(9):894–900.CrossRef
13.
go back to reference Mulvogue K, Roberts JA, Coombes I, Cottrell N, Kanagarajah S, Smith A. The effect of pharmacists on ward rounds measured by the STOPP/START tool in a specialized geriatric unit. J Clin Pharm Ther. 2017;42(2):178–84.CrossRef Mulvogue K, Roberts JA, Coombes I, Cottrell N, Kanagarajah S, Smith A. The effect of pharmacists on ward rounds measured by the STOPP/START tool in a specialized geriatric unit. J Clin Pharm Ther. 2017;42(2):178–84.CrossRef
14.
go back to reference El Morabet N, Uitvlugt EB, van den Bemt BJF, van den Bemt PMLA, Janssen MJA, Karapinar-Çarkit F. Prevalence and preventability of drug-related hospital readmissions: a systematic review. J Am Geriatr Soc. 2018;66(3):602–8.CrossRef El Morabet N, Uitvlugt EB, van den Bemt BJF, van den Bemt PMLA, Janssen MJA, Karapinar-Çarkit F. Prevalence and preventability of drug-related hospital readmissions: a systematic review. J Am Geriatr Soc. 2018;66(3):602–8.CrossRef
15.
go back to reference Vo T-H, Charpiat B, Catoire C, Juste M, Roubille R, Rose F-X, et al. Tools for Assessing Potential Significance of Pharmacist Interventions: A Systematic Review. Drug Saf. 2016;39(2):131–46.CrossRef Vo T-H, Charpiat B, Catoire C, Juste M, Roubille R, Rose F-X, et al. Tools for Assessing Potential Significance of Pharmacist Interventions: A Systematic Review. Drug Saf. 2016;39(2):131–46.CrossRef
16.
go back to reference Allenet B, Bedouch P, Rose F-X, Escofier L, Roubille R, Charpiat B, et al. Validation of an instrument for the documentation of clinical pharmacists’ interventions. Pharm World Sci PWS. 2006;28(4):181–8.CrossRef Allenet B, Bedouch P, Rose F-X, Escofier L, Roubille R, Charpiat B, et al. Validation of an instrument for the documentation of clinical pharmacists’ interventions. Pharm World Sci PWS. 2006;28(4):181–8.CrossRef
17.
go back to reference Bedouch P, Sylvoz N, Charpiat B, Juste M, Roubille R, Rose F-X, et al. Trends in pharmacists’ medication order review in French hospitals from 2006 to 2009: analysis of pharmacists’ interventions from the Act-IP© website observatory. J Clin Pharm Ther. 2015;40(1):32–40.CrossRef Bedouch P, Sylvoz N, Charpiat B, Juste M, Roubille R, Rose F-X, et al. Trends in pharmacists’ medication order review in French hospitals from 2006 to 2009: analysis of pharmacists’ interventions from the Act-IP© website observatory. J Clin Pharm Ther. 2015;40(1):32–40.CrossRef
19.
go back to reference Stämpfli D, Baumgartner P, Boeni F, Bedouch P, Lampert ML, Hersberger KE. Translation and validation of a tool to assess the impact of clinical pharmacists’ interventions. Int J Clin Pharm. 2019;41(1):56–64.CrossRef Stämpfli D, Baumgartner P, Boeni F, Bedouch P, Lampert ML, Hersberger KE. Translation and validation of a tool to assess the impact of clinical pharmacists’ interventions. Int J Clin Pharm. 2019;41(1):56–64.CrossRef
20.
go back to reference Mouchoux C, Viprey M, Loue C, Ottomani H, Bezel C, Divoux E, et al. Intégration du pharmacien-clinicien dans l’optimisation thérapeutique des patients avec troubles neurocognitifs pris en charge en unité cognitivocomportementale. Cah Année Gérontologique. 2014;6(2):37–43.CrossRef Mouchoux C, Viprey M, Loue C, Ottomani H, Bezel C, Divoux E, et al. Intégration du pharmacien-clinicien dans l’optimisation thérapeutique des patients avec troubles neurocognitifs pris en charge en unité cognitivocomportementale. Cah Année Gérontologique. 2014;6(2):37–43.CrossRef
21.
go back to reference Ziane A, Ngami C, Youb R, Atri MH, Aikpa R, Kabirian F, et al. Evaluating the quality of pharmacists’ interventions in older patient than 75 years. J Pharm Clin. 2013;32(4):243–9. Ziane A, Ngami C, Youb R, Atri MH, Aikpa R, Kabirian F, et al. Evaluating the quality of pharmacists’ interventions in older patient than 75 years. J Pharm Clin. 2013;32(4):243–9.
22.
go back to reference Cortejoso L, Dietz RA, Hofmann G, Gosch M, Sattler A. Impact of pharmacist interventions in older patients: a prospective study in a tertiary hospital in Germany. Clin Interv Aging. 2016;11:1343–50.CrossRef Cortejoso L, Dietz RA, Hofmann G, Gosch M, Sattler A. Impact of pharmacist interventions in older patients: a prospective study in a tertiary hospital in Germany. Clin Interv Aging. 2016;11:1343–50.CrossRef
23.
go back to reference Nguyen TA, Gilmartin-Thomas J, Tan ECK, Kalisch-Ellett L, Eshetie T, Gillam M, et al. The impact of pharmacist interventions on quality use of medicines, quality of life, and health outcomes in people with dementia and/or cognitive impairment: a systematic review. J Alzheimers Dis. 2019;71(1):83–96.CrossRef Nguyen TA, Gilmartin-Thomas J, Tan ECK, Kalisch-Ellett L, Eshetie T, Gillam M, et al. The impact of pharmacist interventions on quality use of medicines, quality of life, and health outcomes in people with dementia and/or cognitive impairment: a systematic review. J Alzheimers Dis. 2019;71(1):83–96.CrossRef
24.
go back to reference Novais T, Mouchoux C. Pharmaceutical care for patients and their caregivers in Alzheimer’s disease and related disorders: a review and new perspectives. Geriatr Psychol Neuropsychiatr Vieil. 2019;17(1):7–19.PubMed Novais T, Mouchoux C. Pharmaceutical care for patients and their caregivers in Alzheimer’s disease and related disorders: a review and new perspectives. Geriatr Psychol Neuropsychiatr Vieil. 2019;17(1):7–19.PubMed
25.
go back to reference Sjölander M, Lindholm L, Pfister B, Jonsson J, Schneede J, Lövheim H, et al. Impact of clinical pharmacist engagement in ward teams on the number of drug-related readmissions among older patients with dementia or cognitive impairment: an economic evaluation. Res Soc Adm Pharm. 2019;15(3):287–91.CrossRef Sjölander M, Lindholm L, Pfister B, Jonsson J, Schneede J, Lövheim H, et al. Impact of clinical pharmacist engagement in ward teams on the number of drug-related readmissions among older patients with dementia or cognitive impairment: an economic evaluation. Res Soc Adm Pharm. 2019;15(3):287–91.CrossRef
26.
go back to reference Hatoum HT, Hutchinson RA, Witte KW, Newby GP. Evaluation of the contribution of clinical pharmacists: inpatient care and cost reduction. Drug Intell Clin Pharm. 1988;22(3):252–9.CrossRef Hatoum HT, Hutchinson RA, Witte KW, Newby GP. Evaluation of the contribution of clinical pharmacists: inpatient care and cost reduction. Drug Intell Clin Pharm. 1988;22(3):252–9.CrossRef
27.
go back to reference Nesbit TW, Shermock KM, Bobek MB, Capozzi DL, Flores PA, Leonard MC, et al. Implementation and pharmacoeconomic analysis of a clinical staff pharmacist practice model. Am J Health Syst Pharm. 2001;58(9):784–90.CrossRef Nesbit TW, Shermock KM, Bobek MB, Capozzi DL, Flores PA, Leonard MC, et al. Implementation and pharmacoeconomic analysis of a clinical staff pharmacist practice model. Am J Health Syst Pharm. 2001;58(9):784–90.CrossRef
28.
go back to reference Bosma L, Jansman FGA, Franken AM, Harting JW, Van den Bemt PMLA. Evaluation of pharmacist clinical interventions in a Dutch hospital setting. Pharm World Sci PWS. 2008;30(1):31–8.CrossRef Bosma L, Jansman FGA, Franken AM, Harting JW, Van den Bemt PMLA. Evaluation of pharmacist clinical interventions in a Dutch hospital setting. Pharm World Sci PWS. 2008;30(1):31–8.CrossRef
29.
go back to reference Yailian A-L, Revel E, Tardy C, Fontana A, Estublier C, Decullier E, et al. Assessment of the clinical relevance of pharmacists’ interventions performed during medication review in a rheumatology ward. Eur J Intern Med. 2019;59:91–6.CrossRef Yailian A-L, Revel E, Tardy C, Fontana A, Estublier C, Decullier E, et al. Assessment of the clinical relevance of pharmacists’ interventions performed during medication review in a rheumatology ward. Eur J Intern Med. 2019;59:91–6.CrossRef
30.
go back to reference Pérez-Moreno MA, Rodríguez-Camacho JM, Calderón-Hernanz B, Comas-Díaz B, Tarradas-Torras J. Clinical relevance of pharmacist intervention in an emergency department. Emerg Med J EMJ. 2017;34(8):495–501.CrossRef Pérez-Moreno MA, Rodríguez-Camacho JM, Calderón-Hernanz B, Comas-Díaz B, Tarradas-Torras J. Clinical relevance of pharmacist intervention in an emergency department. Emerg Med J EMJ. 2017;34(8):495–501.CrossRef
Metadata
Title
Clinical, economic, and organizational impact of pharmacists’ interventions in a cognitive-behavioral unit in France
Authors
Teddy Novais
Fanny Maldonado
Maxime Grail
Pierre Krolak-Salmon
Christelle Mouchoux
Publication date
01-06-2021
Publisher
Springer International Publishing
Published in
International Journal of Clinical Pharmacy / Issue 3/2021
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-020-01172-4

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