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Community pharmacists can improve adherence and quality of life in elderly patients taking at least four medicines, a new UK study reports.

Community pharmacists held regular consultations with 620 patients over 65 years of age, during which they discussed falls, pain management, adherence and general health. Based on a STOPP/START assessment during the initial consultations of 498 patients, pharmacists made 142 recommendations to prescribers for 110 patients. For example:

• 24.6 per cent of the recommendations regarded NSAIDs prescribed for longer than three months
• 19.7 per cent were for proton pump inhibitors prescribed at maximum dosage for more than eight weeks
• 17.6 per cent were for therapeutic duplication
• 4.2 per cent of the recommendations referred to people being prescribed more than one opioid
• 15.5 per cent of the recommendations were for either an opioid or calcium channel blocker prescribed with a tricyclic antidepressant.

The total number of falls declined significantly between baseline and the six-month follow-up, while pain scores showed a non-significant increase. However, pain's effect on day-to-day activities declined. Both medicines adherence and quality of life saw significant improvements. Estimates of the cost per quality-adjusted life year ranged from £11,885 to £32,466 depending on the assumptions.

The authors say that the service could be cost-effective if the six-month gains were maintained at 12 months at no further cost. (Int J Pharm Pract doi:10.1111/ijpp.12196).

The project was conducted by Community Pharmacy Future (CPF), a collaboration between Boots UK, the Cooperative Pharmacy group (now Well), LloydsPharmacy and Rowlands Pharmacy.

• See also April 2015's front cover story.

Pharmacists make positive interventions in elderly