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A retrospective analysis of medication reviews was performed for 372 community-dwelling older people (aged ≥65 years) who received an HMR service from the pharmacist. The main outcome measure was the total DBI score at baseline and post-HMR. The data were also examined to determine the extent of potentially inappropriate medication (PIM) use (2003 Beers' criteria), and the number and nature of pharmacists' recommendations.
To investigate whether Home Medicines Review (HMR) services by pharmacists for community-dwelling older people would lead to an improvement in the use of medications, as measured by a decrease in the Drug Burden Index (DBI) score.
Pharmacists conducted Home Medicines Reviews and made recommendations to general practitioners to reduce or cease medications with sedative and anticholinergic properties.
Accredited pharmacists
Community-dwelling older people (aged ≥65 years) referred for HMR based on standard criteria such as polypharmacy, recent hospital discharge, or use of high-risk medications.
Change in DBI score; prevalence of PIMs; number and nature of pharmacists' recommendations
Pharmacists' recommendations during HMR services, if acted upon, may effect changes in the prescribing of sedative and anticholinergic medications, thereby substantially reducing the patient's drug burden.
Significant reduction in DBI scores and PIM use; positive influence of HMR services on prescribing practices
Uncertainty about the extent to which pharmacist recommendations were implemented; limitations of Beers' criteria applicability outside the US
The study showed a statistically significant reduction in DBI scores and a decrease in PIM use following pharmacist recommendations. The DBI was proposed as a flexible tool for evaluating medication burden.