Effect of the Tool to Reduce Inappropriate Medications on Medication Communication and Deprescribing

Fried, Terri R.; Niehoff, Kristina M.; Street, Richard L.; Charpentier, Peter; Rajeevan, Nallakkandi; Miller, Perry L.; Goldstein, Mary K.; OʼLeary, John R.; Fenton, Brenda T.

doi:10.1111/jgs.15042

Cited by 66 publications

(120 citation statements)

References 25 publications

Supporting

Mentioning

115

Contrasting

Unclassified

Order By: Relevance

“…In all cases, interventions were classified as either delivery arrangements (Basger 2015;Bladh 2011;Bucci 2003;Chiu 2018;Crotty 2004b;Fried 2017;Haag 2016;Koberlein-Neu 2016;Michalek 2014;Milos 2013;Muth 2016;Muth 2018;Olsson 2012;Schmader 2004;Spinewine 2007; Thyrian 2017; Van der Linden 2017), implementation strategies (Franchi 2016;Garcia-Gollarte 2014), or both Clyne 2015;Crotty 2004a;Dalleur 2014;Frankenthal 2014;Gallagher 2011;Hanlon 1996;Pitkala 2014;Tamblyn 2003;Taylor 2003;Trygstad 2005;Trygstad 2009; Wehling 2016) (see Types of interventions for definitions).…”

Section: Interventions¬mentioning

confidence: 99%

“…In community settings, pharmaceutical care services, including medication reviews, patient interviews and counselling, were provided by different healthcare professionals. This included pharmacists working in community-based family medicine clinics (Taylor 2003), or within primary care centres Milos 2013), GP (Clyne 2015;Fried 2017;Koberlein-Neu 2016) and nurses/healthcare assistants (Muth 2016; Muth 2018; Thyrian 2017 ). In nursing homes, interventions involved multi-disciplinary case conferences combined with staff education provided by pharmacists (Crotty 2004a), medication reviews by the study pharmacists and discussed with the chief physician (Frankenthal 2014), training sessions for staff (Garcia-Gollarte 2014;Pitkala 2014), and a drug therapy management service (Trygstad 2005;Trygstad 2009).…”

Section: Interventions¬mentioning

confidence: 99%

“…Following medication reviews, recommendations were discussed with a multi-disciplinary team during case conferences (Crotty 2004a;Crotty 2004b), sent to patient's own GPs or consultants (Basger 2015;Bladh 2011;Frankenthal 2014; Milos 2013; Van der Linden 2017), or discussed with prescribers and followed up by written recommendations (Hanlon 1996) from multi-disciplinary team members at the same outpatient clinic (Bucci 2003), or during inpatient ward rounds (Spinewine 2007). In five studies, medicine reviews were undertaken by the doctor (Clyne 2015;Fried 2017;Muth 2016;Muth 2018;Wehling 2016). In three studies, nurses were asked to identify potential medication-related problems and bring these to the attention of the consulting physician (Pitkala 2014), or conduct prescription reviews (Thyrian 2017), which were sent to the study physician (Olsson 2012).…”

Section: Interventions¬mentioning

confidence: 99%

“…Interventions were delivered over a period of time, for example, during the hospital inpatient stay and at discharge (Bladh 2011;Chiu 2018;Franchi 2016;Haag 2016;Michalek 2014;Schmader 2004;Spinewine 2007; Van der Linden 2017), or over several clinic visits and over several months on an ongoing basis (Tamblyn 2003). Interventions were also delivered at the time of an event, for example, following hospital admission (Dalleur 2014;Gallagher 2011), at discharge from hospital (Basger 2015), during attendance at outpatient clinics (Bucci 2003;Hanlon 1996;Schmader 2004;Taylor 2003), at nursing home visits (Crotty 2004a;Trygstad 2005;Trygstad 2009), at hospital discharge to a nursing home (Crotty 2004b), home visit by a nurse (Olsson 2012), or GP visit Clyne 2015;Fried 2017;Muth 2016;Muth 2018). In studies for which details of intervention administration were provided, interventions were most commonly administered during a single episode of care (Bucci 2003;Crotty 2004a;Hanlon 1996;Tamblyn 2003;Taylor 2003;Trygstad 2005;Trygstad 2009).…”

Section: / 211mentioning

confidence: 99%

See 3 more Smart Citations

Interventions to improve the appropriate use of polypharmacy for older people

Rankin

Cadogan

Patterson³

et al. 2018

Cochrane Database of Systematic Reviews

342

408

View full text Add to dashboard Cite

show abstract

Section: Interventions¬mentioning

confidence: 99%

Section: Interventions¬mentioning

confidence: 99%

Section: Interventions¬mentioning

confidence: 99%

Section: / 211mentioning

confidence: 99%

See 2 more Smart Citations

Interventions to improve the appropriate use of polypharmacy for older people

Rankin

Cadogan

Patterson³

et al. 2018

Cochrane Database of Systematic Reviews

342

408

View full text Add to dashboard Cite

show abstract

“…Furthermore, exploring the functionality and utilization of clinical decision support systems beyond identification and prevention of drug‐drug interactions could support patient safety in the provision of community pharmacist patient care services across the medication use process. Clinical decision support systems were used in other care settings to support accurate diagnosis, appropriate and evidence‐based therapy selection, patient follow‐up, patient‐provider communication regarding medication, and documentation, among others.…”

Section: Discussionmentioning

confidence: 99%

Innovative Advances in Connectivity and Community Pharmacist Patient Care Services: Implications for Patient Safety

Bacci

Berenbrok

2018

Pharmacotherapy

View full text Add to dashboard Cite

The scope of community pharmacy practice has expanded beyond the provision of drug product to include the provision of patient care services. Likewise, the community pharmacist's approach to patient safety must also expand beyond prevention of errors during medication dispensing to include optimization of medications and prevention of adverse events throughout the entire medication use process. Connectivity to patient data and other health care providers has been a long-standing challenge in community pharmacy with implications for the delivery and safety of patient care. We describe three innovative advances in connectivity in community pharmacy practice that enhance patient safety in the provision of community pharmacist patient care services across the entire medication use process. Specifically, we discuss the growing use of immunization information systems, quality improvement platforms, and health information exchanges in community pharmacy practice and their implications for patient safety.

show abstract

Effectiveness of Bundled Hyperpolypharmacy Deprescribing Compared With Usual Care Among Older Adults

Herrinton

Alavi

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceOlder patients using many prescription drugs (hyperpolypharmacy) may be at increased risk of adverse drug effects.ObjectiveTo test the effectiveness and safety of a quality intervention intended to reduce hyperpolypharmacy.Design, Setting, and ParticipantsThis randomized clinical trial allocated patients 76 years or older who used 10 or more prescription medications to a deprescribing intervention or to usual care (1:1 ratio) at an integrated health system with multiple preexisting deprescribing workflows. Data were collected from October 15, 2020, to July 29, 2022.InterventionPhysician-pharmacist collaborative drug therapy management, standard-of-care practice recommendations, shared decision-making, and deprescribing protocols administered by telephone over multiple cycles for a maximum of 180 days after allocation.Main Outcomes and MeasuresPrimary end points were change in the number of medications and in the prevalence of geriatric syndrome (falls, cognition, urinary incontinence, and pain) from 181 to 365 days after allocation compared with before randomization. Secondary outcomes were use of medical services and adverse drug withdrawal effects.ResultsOf a random sample of 2860 patients selected for potential enrollment, 2470 (86.4%) remained eligible after physician authorization, with 1237 randomized to the intervention and 1233 to usual care. A total of 1062 intervention patients (85.9%) were reached and agreed to enroll. Demographic variables were balanced. The median age of the 2470 patients was 80 (range, 76-104) years, and 1273 (51.5%) were women. In terms of race and ethnicity, 185 patients (7.5%) were African American, 234 (9.5%) were Asian or Pacific Islander, 220 (8.9%) were Hispanic, 1574 (63.7%) were White (63.7%), and 257 (10.4%) were of other (including American Indian or Alaska Native, Native Hawaiian, or &gt;1 race or ethnicity) or unknown race or ethnicity. During follow-up, both the intervention and usual care groups had slight reductions in the number of medications dispensed (mean changes, −0.4 [95% CI, −0.6 to −0.2] and −0.4 [95% CI, −0.6 to −0.3], respectively), with no difference between the groups (P = .71). There were no significant changes in the prevalence of a geriatric condition in the usual care and intervention groups at the end of follow-up and no difference between the groups (baseline prevalence: 47.7% [95% CI, 44.9%-50.5%] vs 42.9% [95% CI, 40.1%-45.7%], respectively; difference-in-differences, 1.0 [95% CI, −3.5 to 5.6]; P = .65). No differences in use of medical services or adverse drug withdrawal effects were observed.Conclusions and RelevanceIn this randomized clinical trial from an integrated care setting with various preexisting deprescribing workflows, a bundled hyperpolypharmacy deprescribing intervention was not associated with reduction in medication dispensing, prevalence of geriatric syndrome, utilization of medical services, or adverse drug withdrawal effects. Additional research is needed in less integrated settings and in more targeted populations.Trial RegistrationClinicalTrials.gov Identifier: NCT05616689

show abstract

Effect of the Tool to Reduce Inappropriate Medications on Medication Communication and Deprescribing

Cited by 66 publications

References 25 publications

Interventions to improve the appropriate use of polypharmacy for older people

Interventions to improve the appropriate use of polypharmacy for older people

Innovative Advances in Connectivity and Community Pharmacist Patient Care Services: Implications for Patient Safety

Effectiveness of Bundled Hyperpolypharmacy Deprescribing Compared With Usual Care Among Older Adults

Contact Info

Product

Resources

About