1. Drugs Aging. 2012 Jun 1;29(6):495-510. doi: 10.2165/11631720-000000000-00000.

The role of the pharmacist in optimizing pharmacotherapy in older people.

Spinewine A, Fialová D, Byrne S.

Universit catholique de Louvain Louvain Drug Research Institute, Brussels,
Belgium. anne.spinewine@uclouvain.be

Prescription of medicines is a fundamental component of the care of older people,
but evidence suggests that pharmacotherapy in this population is often
inappropriate. Pharmacists have been involved in different approaches for the
optimization of prescribing and rational medication use in older people. This
article describes the different models of care in which pharmacists are involved 
in the optimization of pharmacotherapy in older people, and reviews the impact of
these approaches on both process and outcome measures. The provision of
pharmaceutical care, medication reviews and educational interventions by
pharmacists in the nursing home, ambulatory and acute care settings are
discussed. We selected systematic reviews, reviews and original studies, and for 
the latter, we focused more specifically on European publications published
between 2001 and 2011. From the literature reviewed, it is clear that when
pharmacists play a proactive role in performing medication reviews and in the
active education of other healthcare professionals, pharmacotherapy for older
patients is improved. However, the evidence of the impact of pharmacists'
interventions on health outcomes, quality of life or cost effectiveness of care
is mixed. Better results have been reported when pharmacists are skilled and work
in the context of a multidisciplinary team. Opportunities remain for multicentre,
European-based, pharmacist-intervention trials in all settings, to determine the 
effectiveness and economic benefit of pharmacist involvement in the optimization 
of pharmacotherapy in older people.

PMID: 22642783  [PubMed - in process]