Abstract

BACKGROUND
Patients with diabetes or cardiovascular disease are at risk of reduced renal function and frequently use drugs that interact with renal function. GPs monitor renal function in these patients. Computerised prescription systems produce alerts in patients labelled as having chronic kidney disease, but alerts are often ignored. If pharmacists use a pharmacy medication alert system (PMAS) based on renal function, they can provide the GP with therapeutic advice to optimise the medication. The extent of this advice and the feasibility in the clinical context are unknown.
AIM
To assess the therapeutic advice formulated by pharmacists with help of a PMAS based on the renal function of patients aged ≥70 years with diabetes or cardiovascular disease.
DESIGN AND SETTING
Observational study in primary health care in the Netherlands.
METHOD
GPs provided pharmacists with the renal function of older patients with diabetes or cardiovascular disease who were using target drugs, that is, drugs requiring therapeutic advice in patients with reduced renal function. With the help of a PMAS, pharmacists assessed the actual medication. The GP weighed the advice in relation to the clinical context of the individual patient.
RESULTS
Six hundred and fifty patients were prescribed 1333 target drugs. Pharmacists formulated 143 therapeutic recommendations (11% of target drugs) concerning 89 patients (13.7% of study population). In 71 recommendations in 52 patients (8.0% of study population), the GP agreed immediately.
CONCLUSION
The use of a PMAS resulted in therapeutic advice in 11% of the target drugs. After weighing the clinical context, the GP agreed with half of the advice.

Links

Publisher Full Text

Authors

Geerts AF, Scherpbier-de Haan ND, de Koning FH, van der Sterren TM, van Weel C, Vervoort GM, de Smet PA, de Grauw WJ

Institution

Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands. a.f.j.geerts@uu.nl

Source

The British journal of general practice : the journal of the Royal College of General Practitioners 62:601 2012 Aug pg e525-9

MeSH

Adrenergic beta-Antagonists
Aged
Aged, 80 and over
Angiotensin II Type 1 Receptor Blockers
Counseling
Diabetic Angiopathies
Diuretics
Female
General Practice
Glomerular Filtration Rate
Humans
Hypoglycemic Agents
Interprofessional Relations
Male
Medical Order Entry Systems
Netherlands
Pharmacy
Prescription Drugs
Renal Insufficiency, Chronic

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22867675