A systematic approach to improving pharmacotherapy in the elderly

Abstract: The aim of this thesis was to investigate whether a structured and systematic approach on improving pharmacotherapy in the elderly (the LIMM-model) would lead to a more appropriate and accurate drug use in the elderly. The elderly use many drugs and are more prone to suffer from adverse drug reaction. It is therefore important to address the quality of their drug therapy. The first study presented in this thesis showed that medication errors in the transition of care are common. These results contributed to the development of the LIMM-model. The model consists of patient medication interview at admission (including medication reconciliation), medication review during the hospital stay and a discharge summary with a medication report at discharge (including medication reconciliation). The activities are performed by the clinical pharmacists and the health care team in close collaboration. The opportunity to study the full model arose as the department of internal medicine at Landskrona Hospital was interested in improving drug therapy in the elderly by using clinical pharmacy services. We therefore started the Landskrona Integrated Medicines management – the LIMM-study. The studies presented here add information and knowledge on clinical relevant topics regarding drug therapy in the elderly, as great room for improvement has been shown to exist in this field. The LIMM-model can help improve the drug therapy in the individual patient, the transfer of information between care levels, is highly appreciated by the health care personnel and is considered very beneficial both for the health care personnel and for the patients.