Medication-related problems identified in home medicines reviews conducted in an Australian rural setting.

ABSTRACT

OBJECTIVE: To analyze the prevalence, nature, and patterns of medication-related problems (MRPs) and to explore relationships between these and the patterns of medication usage and clinical characteristics of the patients for whom Home Medicines Reviews (HMRs) were provided. DESIGN: Retrospective analysis of 100 HMR reports. MRPs were grouped according to class. Analysis of medication usage patterns was undertaken using standard systems for classification of therapeutic actions and dosage intensity. SETTING: In Australia, accredited pharmacists conduct HMRs through the federally funded HMR program, aiming to detect and prevent or resolve MRPs. INTERVENTIONS: This study analyzed HMR reports for a cohort of home-dwelling patients living in a small rural community in South Australia. MAIN OUTCOME MEASURE: MRPs were characterized and analyzed by drug class and dosage intensity. RESULTS: 130 MRPs were identified in 73 patients (mean ± standard deviation 1.30 ± 1.22 per patient). The most common types of problems were an untreated indication for treatment and failure to receive medication (both n = 23), followed by adverse drug events (n = 21), drugdrug interactions, and improper drug selection (n = 19). Cardiovascular, central nervous system, and musculoskeletal agents were the classes most frequently associated with MRPs. CONCLUSION: Medication-usage patterns were similar to those observed in previous research conducted in urban settings, both in Australia and internationally. The findings lend further support for an expanded role for pharmacists in the primary health care system, suggesting that HMRs and the medication review process can improve medication use and overall patient health outcomes.