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A Composite Screening Tool for Medication Reviews of Outpatients

General Issues with Specific Examples

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Abstract

Regular performance of medication reviews is prominent among methods that have been advocated to reduce the extent and seriousness of drug-related problems, such as adverse drug reactions, drug-disease interactions, drug-drug interactions, drug ineffectiveness and cost ineffectiveness. Several screening tools have been developed to guide practising healthcare professionals and researchers in reviewing the medication patterns of elderly patients; however, each of these tools has its own limitations. This review discusses a wide range of general prescription-, treatment- and patient-related issues that should be taken into account when reviewing medication patterns by implicit screening. These include generic and therapeutic substitution; potentially superfluous or inappropriate medications; potentially inappropriate dosages or duration of treatment; drug-disease and drug-drug interactions; under-treatment; making use of laboratory test results; patient adherence, experiences and habits; appropriate dosage forms and packaging. A broad selection of specific examples and references that can be used as a basis for explicit screening of medication patterns in outpatients is also offered.

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Acknowledgements

Peter A.G.M. De Smet works for the Scientific Institute Dutch Pharmacists, which is financially dependent on the Royal Dutch Society for the Advancement of Pharmacy (the professional pharmaceutical association in The Netherlands). The authors have no other sources of funding or conflicts of interest that are directly relevant to the content of this review.

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Authors and Affiliations

  1. Scientific Institute Dutch Pharmacists, Alexanderstraat 11, 2514 JL, The Hague, The Netherlands

    Peter A. G. M. De Smet

  2. Department of Clinical Pharmacy, University Medical Centre, Radboud University Nijmegen, Nijmegen, The Netherlands

    Peter A. G. M. De Smet

  3. Apotheek Meindersma, Deventer, The Netherlands

    Wilma Denneboom

  4. Centre for Quality of Care Research, University Medical Centre, Radboud University Nijmegen, Nijmegen, The Netherlands

    Wilma Denneboom & Richard Grol

  5. Department of Pharmacology and Toxicology, Radboud University Nijmegen, Nijmegen, The Netherlands

    Cees Kramers

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De Smet, P.A.G.M., Denneboom, W., Kramers, C. et al. A Composite Screening Tool for Medication Reviews of Outpatients. Drugs Aging 24, 733–760 (2007). https://doi.org/10.2165/00002512-200724090-00003

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