Innovation update: Screening tool helps pharmacists flag drug-related problems

When the MedsCheck program was first introduced in Ontario, many individuals thought medication reviews were just a list, says Karen Riley, a pharmacist consultant based in Sarnia, Ontario. That bothered her because she knew medication reviews could be useful in uncovering drug-related problems (DRPs), especially in the elderly on multiple meds. She also knew there were valuable screening tools to assist pharmacists in identifying more complicated DRPs.

So, she set out to prove it. With support from the Canadian Foundation for Pharmacy (CFP)’s Innovation Fund, Riley and her team developed a pilot study to determine whether clinical decision support systems (CDSS) such as the QMR software tool used during MedsChecks could help pharmacists flag more DRPs. As Riley suspected, the answer was positive. “The overall value in using the tool was that it captured potential issues with a minimal amount of time…and grouped all the problems together,” said Riley in presenting the study results at the Innovation Showcase hosted by CFP in June.

During the pilot study five pharmacists completed MedChecks in three phases over three months. Phases 1 and 3 were using standard medication review, while phase 2 included training and use of the CDSS tool, which is based on algorithms and evidence-based sources like the Beers criteria. “There were more potential DRPs identified per patient in phase 2 compared to phase 1 or phase 3,” says Riley.

“Overall, pharmacists rated the CDSS (QMR) very positively with respect to ease of use,” says Riley, noting that they also found moderate improvements in pharmaceutical care and in identifying additional health outcomes.

Riley also noted that this tool is already embedded into medication reviews used in Germany with favorable results. “Our findings provide initial support for the use of CDSS in facilitating effective medication reviews, particularly, for older adults,” said Riley.