Background: The prevalence rate of chronic diseases in Taiwan is 5.3-14.83%, and 26% of people over 65 years old suffer from multiple chronic diseases. Analysis of the middle-aged and elderly people in Taiwan, the researchers found that the highest medical expenses are the patients with more than 5 comorbidities, and the average annual medical expenses are about NT$140,000.
Objectives: The purpose of this study is to analyze medication reconciliation retrospectively. The pharmacists involved in the multi-drug integration of the chronic diseases patients, evaluation the effectiveness of pharmaceutical care and reduce the waste of medical resources directly and indirectly.
Methods: This was a retrospective cohort study to collect medical records from January 2019 to December 2019. Inclusion criteria were (a) prescription days≧28 days; (b) diagnosed 3 or more chronic diseases; (c) prescribed drugs 10 or more. Descriptive statistics were performed in the classes of medication evaluation and recommendations, physicians’ acceptance of pharmacists’ recommendations, changes in the number of drug items, and indirect reductions in medical expenses, etc. Statistical analysis of pharmacy care effectiveness and indirect reduction of waste of medical resources with SPSS version 18.
Results: This study included 497 patients. There were 97 patients (19.52%) who required the pharmacists’ intervention to initiate the care and assessment process. The acceptance rate of pharmacists’ recommendations was 51.1% and maintained the original prescription due to the clinical consideration was 48.9%. Classes of pharmacists’ recommendations included (1) replaced medicines (93.48%), and (2) adjusted administration frequency (6.52%). The overall benefit contained direct savings in the number of medicines up to NT$30,574 and indirect savings in the amount of NT$23,264. The indirect savings embodied the pharmaceutical care intervention to avoid the drug-related adverse events which reduced subsequent hospitalization and total medical expenses.3
Conclusions: The pharmacists assisted to interpret the cloud medication history actively before the patient visited the clinic. Pharmacists conducted a comprehensive medication review and provided medication recommendations for the physicians’ reference. It was expected that it will reduce the repeated prescription of drugs, reduced the risk of medication duplicate across hospitals, improved patient awareness, and assisted patients to integrate chronic medication use. Pharmacists and healthcare professional teams worked together to ensure the effectiveness and safety of medications.
