Impact of a pharmacist’s presence on medication usage in Long-Term Care
Facilities: a retrospective cohort study
Abstract
Aim. To investigate the impact of pharmacists’ presence in long-term
care facilities (LTCFs) on medication usage. Methods. The study followed
a retrospective cohort design, with a sample of patients aged ≥ 65 years
old admitted to 3 LTCFs over 30 months. Data on age, gender, type of
stay, presence/absence of pharmacist and medication at admission and
discharge were obtained for study patients. Variations in the number of
medicines (NoM), anticholinergic burden (ACB), and potentially
inappropriate medication (PIMs), at admission and discharge, were
assessed as outcome variables. Anticholinergic burden and PIMs were
identified using the Anticholinergic Cognitive Burden scale and the
EU(7)-PIM List, respectively. One-sample t-tests were applied to compare
outcome variables’ mean values at admission and discharge. A 4-way ANOVA
was employed to test the association between background and outcome
variables. Partial Eta squared (η2) was used to measure the effect size.
Results. The 3 LTCFs assisted 1643 patients during the study period, of
which 1366 were included in data analysis. Only one LTCF had pharmacy
services. All outcome variables showed a statistically significant
increase at discharge compared with admission. Pharmacist’s presence was
statistically significant at improving the NoM (p<0.001) and
ACB score (p<0.001), while no statistically significant value
was reached on PIMs (p = 0.642). Small effect size values were reached
for pharmacist impact on the NoM and ACB score (η2 = 0.021, η2 = 0.011,
respectively). Conclusion. The present findings suggest that
pharmacists’ presence positively impacts the use of medications
implicated in adverse health outcomes in LTC patients.