Clinical pharmacist implementation of a medication assessment tool for long-term management of atrial fibrillation in older persons
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| Format: | Artículo científico |
| Language: | en |
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Centro de investigaciones y Publicaciones Farmacéuticas
2019
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| _version_ | 1876434772859813888 |
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| author | Marise Gauci |
| author_facet | Marise Gauci |
| contents | Clinical pharmacist implementation of a medication assessment tool for long-term management of atrial fibrillation in older persons Marise Gauci Francesca Wirth Lilian M. Azzopardi Anthony Serracino-Inglott Medicina Aged Malta Pharmacists Clinical Audit Disease Management Background: Optimisation of drug therapy is important in the older population and may be facilitated by medication assessment tools (MATs).Objective: The purpose of the study was to evaluate whether appropriateness of drug therapy and clinical pharmacist intervention documentation improved following implementation of a previously developed MAT for the long-term management of atrial fibrillation (MAT-AF).Methods: Adherence to MAT-AF review criteria and clinical pharmacist intervention documentation was assessed by the researcher pre-MAT implementation in 150 patients aged ≥60 years admitted to a rehabilitation hospital with a diagnosis of atrial fibrillation. MAT-AF was introduced as a clinical tool in the hospital for identification of pharmaceutical care issues in atrial fibrillation patients. Adherence to MAT-AF and pharmacist intervention documentation were assessed by the researcher post-MAT implementation for a further 150 patients with the same inclusion criteria. Logistic regression analysis and measurement of odds ratio was used to identify differences in adherence to MAT-AF pre- and post-MAT implementation. The differences between two population proportions z-test was used to compare pharmacist intervention documentation pre- and post-MAT implementation.Results: Adherence to MAT-AF criteria increased from 70.9% pre-implementation to 89.6% post-implementation. MAT-AF implementation resulted in a significant improvement in prescription of anticoagulant therapy (OR 4.07, p<0.001) and monitoring of laboratory parameters for digoxin (OR 10.40, p<0.001). Clinical pharmacist intervention documentation improved significantly post-implementation of MAT-AF (z-score 20.249, p<0.001).Conclusions: Implementation of MAT-AF within an interdisciplinary health care team significantly improved the appropriateness of drug therapy and pharmacist intervention documentation in older patients with atrial fibrillation. 2019 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69060019004 https://www.redalyc.org/journal/690/69060019004/ https://www.redalyc.org/journal/690/69060019004/html/ https://www.redalyc.org/journal/690/69060019004/69060019004.epub https://www.redalyc.org/journal/690/69060019004/movil 10.18549/PharmPract.2019.1.1349 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.1 Vol.17 |
| format | Artículo científico |
| id | redalyc_69060019004 |
| institution | Redalyc |
| language | en |
| publishDate | 2019 |
| publisher | Centro de investigaciones y Publicaciones Farmacéuticas |
| spellingShingle | Clinical pharmacist implementation of a medication assessment tool for long-term management of atrial fibrillation in older persons Marise Gauci Medicina Aged Malta Pharmacists Clinical Audit Disease Management Clinical pharmacist implementation of a medication assessment tool for long-term management of atrial fibrillation in older persons Marise Gauci Francesca Wirth Lilian M. Azzopardi Anthony Serracino-Inglott Medicina Aged Malta Pharmacists Clinical Audit Disease Management Background: Optimisation of drug therapy is important in the older population and may be facilitated by medication assessment tools (MATs).Objective: The purpose of the study was to evaluate whether appropriateness of drug therapy and clinical pharmacist intervention documentation improved following implementation of a previously developed MAT for the long-term management of atrial fibrillation (MAT-AF).Methods: Adherence to MAT-AF review criteria and clinical pharmacist intervention documentation was assessed by the researcher pre-MAT implementation in 150 patients aged ≥60 years admitted to a rehabilitation hospital with a diagnosis of atrial fibrillation. MAT-AF was introduced as a clinical tool in the hospital for identification of pharmaceutical care issues in atrial fibrillation patients. Adherence to MAT-AF and pharmacist intervention documentation were assessed by the researcher post-MAT implementation for a further 150 patients with the same inclusion criteria. Logistic regression analysis and measurement of odds ratio was used to identify differences in adherence to MAT-AF pre- and post-MAT implementation. The differences between two population proportions z-test was used to compare pharmacist intervention documentation pre- and post-MAT implementation.Results: Adherence to MAT-AF criteria increased from 70.9% pre-implementation to 89.6% post-implementation. MAT-AF implementation resulted in a significant improvement in prescription of anticoagulant therapy (OR 4.07, p<0.001) and monitoring of laboratory parameters for digoxin (OR 10.40, p<0.001). Clinical pharmacist intervention documentation improved significantly post-implementation of MAT-AF (z-score 20.249, p<0.001).Conclusions: Implementation of MAT-AF within an interdisciplinary health care team significantly improved the appropriateness of drug therapy and pharmacist intervention documentation in older patients with atrial fibrillation. 2019 artículo científico 1885-642X https://www.redalyc.org/articulo.oa?id=69060019004 https://www.redalyc.org/journal/690/69060019004/ https://www.redalyc.org/journal/690/69060019004/html/ https://www.redalyc.org/journal/690/69060019004/69060019004.epub https://www.redalyc.org/journal/690/69060019004/movil 10.18549/PharmPract.2019.1.1349 en http://www.redalyc.org/revista.oa?id=690 Pharmacy Practice application/pdf Centro de investigaciones y Publicaciones Farmacéuticas Pharmacy Practice (España) Num.1 Vol.17 |
| title | Clinical pharmacist implementation of a medication assessment tool for long-term management of atrial fibrillation in older persons |
| topic | Medicina Aged Malta Pharmacists Clinical Audit Disease Management |
| url | https://www.redalyc.org/articulo.oa?id=69060019004 https://www.redalyc.org/journal/690/69060019004/ https://www.redalyc.org/journal/690/69060019004/html/ https://www.redalyc.org/journal/690/69060019004/69060019004.epub https://www.redalyc.org/journal/690/69060019004/movil |