| dc.description.abstract | Abstract: Background: The number of elderly is increasing, as well as the prescription rate and consumption of drugs in the Norwegian health system. Old, multimorbid patients are often treated with several drugs simultaneously. This, in combination with age-related changes in pharmacodynamics and pharmacokinetics, increases the risk of drug-related problems and interactions. Over the last few years there has been an increased focus on interventions to improve pharmacotherapy in Norwegian nursing homes. One of these interventions is medication reviews. Aim: The aim of this thesis is to highlight medication review as a topic. What does the concept include, which tools are relevant, which participants play a role, and what are the effects of medication reviews? Method: Literature review based on PubMed search. Two searches resulted in 29 articles. 10 of these were considered relevant, and included. Four studies were included from the reference-list of other relevant studies. To highlight relevant tools, I found studies based on tools used in the relevant studies, and in Norwegian guidelines. Results: The Norwegian guidelines from The Norwegian Directorate of Health defines medication review as «a systematic approach to assess individual patient drug use, to secure effect and safety» There are a numbers of tools developed to secure better prescription, i.a. the START/STOP-criteria, NorGep-criteria, databases for drug-drug interactions, and a systematic process described for medication reviews. Most studies show a significant effect on outcomes concerning drug-use and drug related problems. Most studies testing health outcomes and hard end-points, however, show no significant effect. The overall quality of the evidence for the outcomes reported is often low. Several studies show a significant effect for medication reviews performed in multidisciplinary teams including a pharmacist. Conclusion: Medication review is an effective intervention for assessing drug-use and to reveal drug-related problems. There is, however, lacking evidence for effect on health outcomes and hard end points. This emphasizes the need for good prospective studies. Several studies claim that the pharmacotherapy in nursing homes should be attended by multidisciplinary teams, including a pharmacist. This will require reorganization, and better routines and collaboration in Norwegian nursing homes. | eng |