Skip to main content
SpringerLink
Log in

Comprehensive medication review: development of a collaborative procedure

  • Commentary
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

This commentary describes the development and evidence-base of the Comprehensive Medication Review (CMR) procedure for community and hospital settings in Finland. The development was coordinated by a national steering group. The group collaborated with 26 experienced pharmacists who developed and tested CMR procedures during a 1.5 year accreditation training for CMR. The development consisted of: (1) a literature review and inventory of medication review procedures in different countries; (2) the creation of potential procedures and related documentation; (3) integration of potential procedures into a national standard procedure; and (4) piloting the standard procedure in practice settings. The resulting comprehensive medication review procedure requires access to a patient’s clinical information, an inhome patient interview and a case conference with the collaborating physician. This procedure covers the four main dimensions critical for safe and appropriate geriatric pharmacotherapy: aging and safety; co-morbidities; polypharmacy; and adherence. The CMR measures and documentation build on these dimensions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL. National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006;296:1858–66.

    Article  PubMed  CAS  Google Scholar 

  2. Jyrkkä J, Vartiainen L, Hartikainen S, Sulkava R, Enlund H. Increasing use of medicines in elderly persons: a 5 year follow-up of the Kuopio 75+ Study. Eur J Clin Pharmacol. 2006;62:151–8.

    Article  PubMed  Google Scholar 

  3. Cipolle R, Strand L, Morley P. Drug therapy problems. In: Pharmaceutical Care Practice. The Clinician’s Guide. 2nd ed. McGraw-Hill: NewYork; 2004. p. 171–200. ISBN: 0-07-136259-2.

  4. Westerlund T, Almarsdóttir A, Melander A. Factors influencing the detection rate of drug-related problems in community pharmacy. Pharm World Sci. 1999;21:245–50.

    Article  PubMed  CAS  Google Scholar 

  5. Sorensen L, Stokes JA, Purdie DM, Woodward M, Elliott R, Roberts MS. Medication reviews in the community: results of a randomized, controlled effectiveness trial. Br J Clin Pharmacol. 2004;58:648–64.

    Article  PubMed  Google Scholar 

  6. American Pharmacists Association; National Association of Chain Drug Stores Foundation. Medication therapy management in pharmacy practice: core elements of an MTM service model (version 2.0). J Am Pharm Assoc. 2003;2008(48):341–53.

    Google Scholar 

  7. The Ministry of Social Affairs and Health, Finland. Safe pharmacotherapy among the aged: obligations for the municipalities (In Finnish). Kuntainfo 6/2007. www.stm.fi/tiedotteet/kuntainfot/kuntainfo/view/1236539. Accessed 2 Sep 2011.

  8. Leikola SN, Tuomainen L, Ovaskainen H, Peura S, Sevón-Vilkman N, Tanskanen P, et al. Continuing education course to attain collaborative comprehensive medication review competencies. Am J Pharm Educ. 2009;73:108.

    Article  PubMed  Google Scholar 

  9. Hakkarainen K. Models of pharmacists-conducted medication review—An international comparison. Master’s Thesis: University of Helsinki; 2008.

    Google Scholar 

  10. Kansanaho H, Puumalainen I, Varunki M, Ahonen R, Airaksinen M. Implementation of a professional program in Finnish community pharmacies in 2000–2002. Patient Educ Couns. 2005;57:272–9.

    Article  PubMed  Google Scholar 

  11. Leikola S Development and application of a comprehensive medication review procedure to community-dwelling elderly [dissertation]. Helsinki: University of Helsinki; 2012. http://urn.fi/URN:ISBN:978-952-10-7698-5. Accessed 16 May 2012.

  12. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of self-reported measure of medication adherence. Med Care. 1986;24:67–74.

    Article  PubMed  CAS  Google Scholar 

  13. Lingjaerde O, Ahlfors UG, Bech P, Dencker SJ, Elgen K. Side effect rating scale. A new comprehensive rating scale for psychotropic drugs and cross-sectional study of side effects in neuroleptic-treated patients. Acta Psychiatr Scand Suppl. 1987;334:1–100.

    Article  PubMed  CAS  Google Scholar 

  14. Brooks R. EuroQol: the current state of play. Health Policy. 1996;37:53–72.

    Article  PubMed  CAS  Google Scholar 

  15. Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH. Updating the beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts. Arch Intern Med. 2003;163:2716–24.

    Article  PubMed  Google Scholar 

  16. Fimea Database of medication for the elderly. http://www.fimea.fi/medicines/medicines_assesment/database_of_medication. Accessed 20 Sep 2011.

  17. National Board of Health and Welfare (Socialstyrelsen). Indicators for evaluation of the quality of drug use in the elderly (In Swedish). http://www.socialstyrelsen.se/Lists/Artikelkatalog/Attachments/18085/2010-6-29.pdf. Accessed 5 Jun 2011.

  18. Cao YJ, Mager DE, Simonsick EM, Hilmer SN, Ling SM, Windham BG, et al. Physical and cognitive performance and burden of anticholinergics, sedatives, and ACE inhibitors in older women. Clin Pharmacol Ther. 2008;83:422–9.

    Article  PubMed  CAS  Google Scholar 

  19. Sorensen L, Stokes JA, Purdie DM, Woodward M, Roberts MS. Medication management at home: medication risk factor prevalence and inter-relationships. J Clin Pharm Ther. 2006;31:485–91.

    Article  PubMed  CAS  Google Scholar 

  20. Yang JC, Tomlinson G, Naglie G. Medication lists for elderly patients: clinic-derived versus in-home inspection and interview. J Gen Intern Med. 2001;16:112–5.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The following persons are acknowledged as key members of the steering group responsible for CMR procedure development: Anne Lehtonen, Centre for Pharmacotherapy Development ROHTO; Harri Ovaskainen, The Finnish Pharmacists’ Association; Nina Sevón-Vilkman, Pharmaceutical Learning Centre; Paavo Tanskanen, University of Eastern Finland. The contribution of Dr. Timothy Chen, University of Sydney, Australia is acknowledged to the CMR procedure development.

Funding

This study was supported through personal grants (SL) from the Association of Finnish Pharmacies and Pharma Industry Finland Research Foundation.

Conflicts of interest

The authors have no conflicts of interest that are relevant to this manuscript.

Author information

Authors and Affiliations

  1. Division of Social Pharmacy, Faculty of Pharmacy, P.O. BOX 56, 00014, University of Helsinki, Finland

    Saija Leikola & Marja Airaksinen

  2. Centre for Training and Development, University of Eastern Finland, P.O. BOX 1627, 70211, Kuopio, Finland

    Lea Tuomainen

  3. The Association of Finnish Pharmacies, Pieni Roobertinkatu 14 C, 00120, Helsinki, Finland

    Sirpa Peura

  4. Ylitornio Pharmacy, Alkkulanraitti 52, 95600, Ylitornio, Finland

    Antti Laurikainen

  5. School of Public and International Affairs, School of Health and Human Services, University of Baltimore, 10W. Preston St., Baltimore, MD, 21201, USA

    Alan Lyles

  6. First Pharmacy in Lohja, Laurinkatu 37-41A, 08100, Lohja, Finland

    Eeva Savela

Authors
  1. Saija Leikola
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lea Tuomainen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sirpa Peura
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Antti Laurikainen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alan Lyles
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eeva Savela
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Marja Airaksinen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Saija Leikola.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leikola, S., Tuomainen, L., Peura, S. et al. Comprehensive medication review: development of a collaborative procedure. Int J Clin Pharm 34, 510–514 (2012). https://doi.org/10.1007/s11096-012-9662-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-012-9662-y

Keywords

Search

Navigation