Description of a practice model for pharmacist medication review in a general practice setting

BACKGROUND Practical descriptions of procedures used for pharmacists' medication reviews are sparse. OBJECTIVE To describe a model for medication review by pharmacists tailored to a general practice setting. METHODS A stepwise model is described. The model is based on data from the medical chart and clinical or laboratory data. The medication review focuses on the diagnoses of the patient instead of the individual drugs. Patient interviews are not part of the model. The model was tested in a pilot study by conducting medical reviews on 50 polypharmacy patients (i.e. receiving 7 or more drugs for regular use). RESULTS The model contained seven main steps. Information about the patient and current treatment was collected in the first three steps, followed by identification of possible interventions related to either diagnoses or drugs in the fourth and fifth step. The sixth and seventh step concerned the reporting of interventions and the considerations of the GPs. 208 interventions were proposed among the 50 patients. The acceptance rate among the GPs was 82%. The most common interventions were lack of clinical or laboratory data (n=57, 27%) and drugs that should be discontinued as they had no indication (n=47, 23%). Most interventions were aimed at cardiovascular drugs. CONCLUSION We have provided a detailed description of a practical approach to pharmacists' medication review in a GP setting. The model was tested and found to be usable, and to deliver a medication review with high acceptance rates.