%0 Journal Article
%T Can Practical Nurses Identify Older Home Care Clients at Risk of Drug
%A Emmi Puumalainen
%A Juha Puustinen
%A Maarit Dimitrow
%A Marja S. A. Airaksinen
%A Paula Viikari
%A Sirkka-Liisa Kivel£¿
%A Tero Vahlberg
%J Journal of Pharmacy Technology
%@ 1549-4810
%D 2018
%R 10.1177/8755122518756332
%X Background: Home care (HC) clients are increasingly older, have many chronic diseases, and use multiple medicines and thus are at high risk for drug-related problems (DRPs). Objective: Establish the sensitivity of practical nurse (PN) administered DRP risk assessment tool (DRP-RAT) compared with geriatrician¡¯s assessment of the medical record. Identify the clinically most significant DRPs needing action. Methods: Twenty-six PNs working in HC of H£¿rk£¿tie Health Center in Lieto, Finland, 46 HC clients (¡Ý65 years), and a geriatrician participated in this pilot study. The geriatrician reviewed HC clients¡¯ medications using 3 different methods. The reviews were based on the following: (1) the PN¡¯s risk screening (ie, PN-completed DRP-RAT) and medication list, (2) health center¡¯s medical records, and (3) methods 1 and 2 together. The main outcome was the number of ¡°at-risk patients¡± (ie, the patient is at risk of clinically significant DRPs) by using each review method. Secondary outcomes were clinically most significant DRP-risk predicting factors identified by the geriatrician. Results: The geriatrician reviewed 45 clients¡¯ medications using all 3 methods. Based on PN-completed DRP-RAT and medication list, 93% (42/45) of the clients were classified as ¡°at-risk patients.¡± Two other review methods resulted in 45/45 (100%) ¡°at-risk patients.¡± Symptoms suggestive of adverse drug reactions were the most significant risk predicting factors. Small sample size limits the generalizability of the results. Conclusions: The PN-completed DRP-RAT was able to provide clinically important timely patient information for clinical decision making. DRP-RAT could make it possible to more effectively involve PNs in medication risk management among older HC clients
%K geriatrics
%K drug-related problem
%K home care services
%K risk management
%K medication safety
%U https://journals.sagepub.com/doi/full/10.1177/8755122518756332