Key result
Implementation of the MAT-AF tool increased adherence to review criteria from 70.9% to 89.6% and significantly improved prescription of anticoagulant therapy (OR 4.07, P<0.001).
Why the study?
Optimisation of drug therapy is important in older populations, but whether implementing a medication assessment tool for atrial fibrillation improves prescribing appropriateness and clinical pharmacist documentation was unknown.
Does the implementation of a medication assessment tool (MAT-AF) improve the appropriateness of drug therapy and pharmacist intervention documentation in older patients with atrial fibrillation?
Observational (n=300)
No
Does the implementation of a medication assessment tool (MAT-AF) improve the appropriateness of drug therapy and pharmacist intervention documentation in older patients with atrial fibrillation?
Absolute Event Rate: 89.6% vs 70.9%
BACKGROUND: Optimisation of drug therapy is important in the older population and may be facilitated by medication assessment tools (MATs). OBJECTIVE: The purpose of the study was to evaluate whether appropriateness of drug therapy and clinical pharmacist intervention documentation improved following implementation of a previously developed MAT for the long-term management of atrial fibrillation (MAT-AF). METHODS: Adherence to MAT-AF review criteria and clinical pharmacist intervention documentation was assessed by the researcher pre-MAT implementation in 150 patients aged ≥60 years admitted to a rehabilitation hospital with a diagnosis of atrial fibrillation. MAT-AF was introduced as a clinical tool in the hospital for identification of pharmaceutical care issues in atrial fibrillation patients. Adherence to MAT-AF and pharmacist intervention documentation were assessed by the researcher post-MAT implementation for a further 150 patients with the same inclusion criteria. Logistic regression analysis and measurement of odds ratio was used to identify differences in adherence to MAT-AF pre- and post-MAT implementation. The differences between two population proportions z-test was used to compare pharmacist intervention documentation pre- and post-MAT implementation. RESULTS: Adherence to MAT-AF criteria increased from 70.9% pre-implementation to 89.6% post-implementation. MAT-AF implementation resulted in a significant improvement in prescription of anticoagulant therapy (OR 4.07, p<0.001) and monitoring of laboratory parameters for digoxin (OR 10.40, p<0.001). Clinical pharmacist intervention documentation improved significantly post-implementation of MAT-AF (z-score 20.249, p<0.001). CONCLUSIONS: Implementation of MAT-AF within an interdisciplinary health care team significantly improved the appropriateness of drug therapy and pharmacist intervention documentation in older patients with atrial fibrillation.
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Gauci et al. (2019) conducted an observational in atrial fibrillation (n=300). Medication assessment tool for atrial fibrillation (MAT-AF) vs. Pre-implementation standard care was evaluated on Adherence to MAT-AF criteria. Implementation of the MAT-AF tool increased adherence to review criteria from 70.9% to 89.6% and significantly improved prescription of anticoagulant therapy (OR 4.07, P<0.001).
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