Amsterdam tool for clinical medication review: development and testing of a comprehensive tool for pharmacists and general practitioners.

ABSTRACT

BACKGROUND: Drug-related problems are prevalent among older patients, and substantially increase the risk of morbidity, (re-)hospitalisation and mortality. To detect drug-related problems and optimize treatment primary caregivers should periodically review the medication of older patients. The aim was to develop a structured, comprehensive but practicable tool to facilitate and support the reviewing of medication of older patients with a chronic disease by pharmacists and general practitioners. METHODS: A tool facilitating clinical medication review by community pharmacists was developed on the basis of treatment guidelines, literature data on drug-related problems. For the identification of drug-related problems from the patient's perspective, a script for structured interviews was developed. The tool was optimized by means of a Delphi method with an expert panel and testing in a trial. RESULTS: The medication review tool consists of a comprehensive checklist of 124 drug-related problems divided by 20 sections according to physiological systems and diseases, and includes a structured interview script for a patient interviews. CONCLUSION: A structured, comprehensive and practical tool to assist pharmacists and general practitioners to perform clinical medication review including a list of potential drug-related problems in older patients with chronic disease, as well as a script for structured patient interviews, was developed.