Medication review practices in European countries

BACKGROUND: Medication review procedures have been developed in many countries to improve rational and safe medication use. The similarities, comprehensiveness, and effectiveness of these procedures has not been assessed, or compared. OBJECTIVE: The aim of this study was to explore medication review practices in European countries. METHODS: An online survey was sent to 32 European countries (all 28 European Union countries and 4 other European countries) by email to one person in each country known to be aware of medication review practices in their country in May 2011. The informants were identified through Pharmaceutical Group of European Union. To complement and validate the information received through Pharmaceutical Group of European Union, medication review experts involved in Pharmaceutical Care Network Europe were contacted. The survey assessed comprehensiveness of the medication review procedures classified according to 3 types in terms of settings; access to patient clinical information; patient involvement; availability of documentation and information; collaboration with the physician; quality control, and training required. RESULTS: Almost two thirds (64%) of the 25 European countries which responded (response rate 78%) indicated having at least one type of medication review procedure in their country. In the community setting prescription (type I) and adherence (type II) medication reviews were the most common (established in 9 and 11 countries, respectively). More comprehensive type III clinical medication reviews requiring access to clinical patient information were still rare, and just being established in 6 countries. CONCLUSIONS: Medication review procedures are becoming common in health care throughout Europe, however improving their comprehensiveness would require better access to patient information for those professionals conducting clinical medication reviews. In addition to benchmarking, the inventory can enhance cooperation between countries and stakeholders involved in medication review practice development nationally and internationally

Medication Review and Medication Reconciliation

Medication review and medication reconciliation are systematic processes with the aim of increasing patient safety as well as effectiveness and efficiency on different levels. Whereas medication reconciliation is defined as the formal process of obtaining a complete and accurate list of each patient's current medications with the main aim of detecting and solving discrepancies, medication review is a structured evaluation of a patient's medications with the aim of detecting and solving drug-related problems (DRPs). The available information determines which DRPs can be detected. If a medication list/plan has to be critically appraised, then the list should first be complete and correct. This makes reconciliation automatically a prerequisite for a medication review