An Algorithm for Comprehensive Medication Management in Nursing Homes: Results of the AMBER Project
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ORIGINAL RESEARCH ARTICLE
An Algorithm for Comprehensive Medication Management in Nursing Homes: Results of the AMBER Project Susanne Erzkamp1 · Juliane Köberlein‑Neu2 · Olaf Rose3,4 Accepted: 19 October 2020 © Springer Nature Switzerland AG 2020
Abstract Introduction There are several barriers to conducting medication management in nursing homes. Our project aimed to develop an algorithm that guides and supports pharmacists to perform this clinical service. Methods Phase I of the project examined the practitioner and patient perspectives on the medication process in nursing homes. The mixed methods approach consisted of interviews with qualitative content analysis and a quantitative questionnaire. Phase IIa scoped existing research and comprised a three-stepped systematic review. It was registered in the International Prospective Register of Systematic Reviews (CRD42017065002). Results of the first two steps were assessed for quality. Phase IIb was performed as a Delphi survey. The developed algorithm was tested in nursing homes. The primary endpoint was the number and type of detected drug-related problems. The study was conducted between June 2016 and December 2018 (Deutsches-Register-Klinischer-Studien-ID: DRKS00010995). Results Interviews were held with 21 healthcare practitioners and six patients. Frequent and relevant aspects of the medication process in nursing homes were identified. The systematic reviews included 28 reviews, 12 interventional studies and 1450 non-interventional studies. As a result of the Delphi survey, two new aspects were added. Testing of the drafted algorithm was done in 73 nursing home residents. A mean of 6.3 drug-related problems were detected. Sample cases were executed in a mean time of 21 min by community pharmacists. Conclusions The developed and consented algorithm can guide pharmacists in conducting medication management in a timely and effective manner. It might serve as a facilitator to improve collaboration and quality of medication in nursing home residents.
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Electronic supplementary material The online version of this article (https://doi.org/10.1007/s40264-020-01016-0) contains supplementary material, which is available to authorized users. * Olaf Rose [email protected] 1
Elefanten-Apotheke gegr. 1575, Steinstr. 14, 48565 Steinfurt, Germany
2
Center for Health Economics and Health Services Research, Schumpeter School of Business and Economics, University of Wuppertal, Rainer‑Gruenter‑Str. 21 Gebäude FN (1. OG), 42119 Wuppertal, Germany
3
impac2t Research, Maximilianstr. 31‑33, 48147 Muenster, Germany
4
Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, 1225 Center Drive HPNP Bldg, Gainesville, FL 32610‑0486, USA
Medication management is beneficial for nursing home residents but is rarely conducted in this setting in Germany. The AMBER project developed an algorithm that can guide pharmacists in conducting medication management for nursing home residents. Implementation of
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