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International Journal of Clinical Pharmacy

20-04-2024 | Dementia | Research Article

Clinical impact of an individualised clinical pharmacy programme into the memory care pathway of older people: an observational study

Authors: Teddy Novais, Elsa Reallon, Julie Martin, Marine Barral, Pierre Krolak-Salmon, Marie-Hélène Coste, Hanane Zenagui, Antoine Garnier-Crussard, Delphine Hoegy, Christelle Mouchoux

Published in: International Journal of Clinical Pharmacy

Abstract

Background

In older patients, medication exposure [i.e. polypharmacy, potentially inappropriate medications (PIMs), medications with anticholinergic and/or sedative properties] is a modifiable risk factor associated with cognitive iatrogenic risk and dementia.

Aim

To assess the potential clinical impact of the implementation of an individualised clinical pharmacy programme at the initiation of the Memory care pathway in older patients with a cognitive complaint.

Method

This prospective observational study included older patients with high-risk of adverse drug event (HR) admitted in a French geriatric university hospital to explore the cognitive complaint or the cognitive disorder between January and November 2021. Drug-related problems (DRPs) were identified during a medication review performed in HR patients, and pharmaceutical interventions (PIs) notified in the patient’s hospitalisation report were collected. The clinical impact of PIs was assessed by an expert panel (geriatricians and clinical pharmacists) using the Clinical, Economic, and Organisational (CLEO) tool.

Results

Overall, 326 patients were eligible and 207 (63.5%) were considered as HR patients. Among HR patients, 88.9% (n = 184) were treated using at least 5 medications (polypharmacy), and 36.7% (n = 76) received at least one PIM with cognitive iatrogenic risk. During the medication review, 490 PIs were provided and their clinical impact was rated as minor for 57.3% (n = 281), moderate for 26.7% (n = 131), and major for 2.5% (n = 12).

Conclusion

The integration of clinical pharmacist secured the Memory care pathway of older patients with a cognitive complaint by identifying an important number of DRPs and PIMs with potential cognitive iatrogenic risk.

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Title: Clinical impact of an individualised clinical pharmacy programme into the memory care pathway of older people: an observational study
Authors: Teddy Novais
Elsa Reallon
Julie Martin
Marine Barral
Pierre Krolak-Salmon
Marie-Hélène Coste
Hanane Zenagui
Antoine Garnier-Crussard
Delphine Hoegy
Christelle Mouchoux
Publication date: 20-04-2024
Publisher: Springer International Publishing
Keywords: Dementia
Dementia
Alzheimer's Disease
Alzheimer's Disease
Published in: International Journal of Clinical Pharmacy
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI: https://doi.org/10.1007/s11096-024-01723-z

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