In this ageing society, older persons are using more and more medications for chronic diseases. During a medication review, the community pharmacist evaluate all the medication use together with the patient in a personal conversation. They discuss whether all the medication is necessary, if there are drugs missing, or if there are side effects or usage problems. Then the pharmacist proposes a pharmaceutical care plan together with the general practitioner to solve these medication problems. These medication reviews are increasingly performed in the Netherlands over the past years.
In our study we investigated how we could further optimise the efficiency and effectiveness of these medication reviews. We chose, in a randomised controlled trial, the DREAMeR study performed with 629 older persons in 35 pharmacies, for a patient-centred approach, because software systems were not specific enough to identify the most important problems for older persons. An innovative aspect of this study was the measurement of personal goals and health-related complaints. The attainment of goals, such as reduction or pain or number of pills, was evaluated with a special measurement scale. 90% of older persons was able to set at least one goal together with the pharmacist and more than 50% of persons improved on their personal goals. In the group of older persons who received a medication review, quality of life improved and the number of health-related complaints with impact on patients’ daily lives decreased. Simultaneously, the number of drugs used decreased. Finally, an economic evaluation showed that there was a high probability that a medication review can lead to cost savings in healthcare expenditure.