Effects of home medication review on drug-related problems and health-related quality of life among community-dwelling older adults in China

Zhang, Sha; Zhu, Deqiu; Zhan, Qiwen; Tian, Lulu; Qian, Shijing; Song, Danfei; Chen, Beilei; Tong, Shanshan; Wang, Jing; Wu, Juan

doi:10.1016/j.japh.2021.10.023

Cited by 7 publications

(8 citation statements)

References 23 publications

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“…Where reported (in 26 out of 33 articles), the mean age of the participants varied from 67.8 years (SD = 7.8) 47 to 82.7 (SD = 6.4). 46 In a minority of studies, the intervention explicitly targeted patients taking multiple medicines 39 , 52 , 55 , 57 , 61 , 70 or living with multiple chronic conditions. 42 , 55 , 66 Some interventions targeted people with specific conditions such as congestive heart failure, 44 hypertension, 49 , 59 diabetes 69 and COPD 62 or taking specific types of medicines, e.g., anticholinergic, 47 anticoagulants 71 or antacids.…”

Section: Resultsmentioning

confidence: 99%

“…In eight articles, education was delivered in conjunction with a medicines review. 39 , 40 , 41 , 45 , 52 , 55 , 70 , 71 In five studies, 47 , 50 , 51 , 68 , 69 education followed assessment of anticholinergic risk, 47 safe management of medicines, 50 ability to manage medicines, 51 diabetes self‐care abilities 69 and comprehensive assessment. 68 Education was delivered both one to one 39 , 40 , 41 , 45 , 48 , 49 , 50 , 51 , 52 , 53 , 55 , 59 , 60 , 64 , 66 , 68 , 70 , 71 and in groups.…”

Section: Resultsmentioning

confidence: 99%

“… 39 , 40 , 41 , 45 , 52 , 55 , 70 , 71 In five studies, 47 , 50 , 51 , 68 , 69 education followed assessment of anticholinergic risk, 47 safe management of medicines, 50 ability to manage medicines, 51 diabetes self‐care abilities 69 and comprehensive assessment. 68 Education was delivered both one to one 39 , 40 , 41 , 45 , 48 , 49 , 50 , 51 , 52 , 53 , 55 , 59 , 60 , 64 , 66 , 68 , 70 , 71 and in groups. 42 , 54 , 56 , 60 , 67 Techniques and tools included coaching, 41 , 48 , 49 , 66 role play, 54 teach‐back/show‐back, 53 , 60 , 66 group discussion, 58 , …”

Section: Resultsmentioning

confidence: 99%

“…A range of HCPs, including pharmacists, pharmacy technicians, nurses, GPs, consultants, researchers, social workers and community workers, were involved. Most interventions were delivered by either a pharmacist, 39 , 52 , 53 , 56 , 57 , 64 , 67 , 70 , 71 a nurse 45 , 48 , 49 , 50 , 51 , 59 or a team of two or more HCPs. 42 , 55 , 61 , 63 , 68 In two articles, 54 , 66 the intervention was led by trained lay people recruited in the community.…”

Section: Resultsmentioning

confidence: 99%

“…The most common intervention component delivered was education about medicines ( n = 26), alone or combined with other components. In eight articles, education was delivered in conjunction with a medicines review 39–41,45,52,55,70,71 . In five studies, 47,50,51,68,69 education followed assessment of anticholinergic risk, 47 safe management of medicines, 50 ability to manage medicines, 51 diabetes self‐care abilities 69 and comprehensive assessment 68 .…”

Section: Resultsmentioning

confidence: 99%

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A rapid review of interventions to improve medicine self‐management for older people living at home

Previdoli

Cheong

Alldred

et al. 2023

Health Expectations

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Background: As people age, they are more likely to develop multiple long-term conditions that require complicated medicine regimens. Safely self-managing multiple medicines at home is challenging and how older people can be better supported to do so has not been fully explored. Aim: This study aimed to identify interventions to improve medicine self-management for older people living at home and the aspects of medicine self-management that they address. Design: A rapid review was undertaken of publications up to April 2022. Eight databases were searched. Inclusion criteria were as follows: interventions aimed at people 65 years of age or older and their informal carers, living at home. Interventions needed to include at least one component of medicine self-management. Study protocols, conference papers, literature reviews and articles not in the English language were not included. The results from the review were reported through narrative synthesis, underpinned by the Resilient Healthcare theory. Results: Database searches returned 14,353 results. One hundred and sixty-seven articles were individually appraised (full-text screening) and 33 were included in the review. The majority of interventions identified were educational. In most cases, they aimed to improve older people's adherence and increase their knowledge of medicines. Only very few interventions addressed potential issues with medicine supply. Only a minority of interventions specifically targeted older people with either polypharmacy, multimorbidities or frailty.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

A rapid review of interventions to improve medicine self‐management for older people living at home

Previdoli

Cheong

Alldred

et al. 2023

Health Expectations

View full text Add to dashboard Cite

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Credentialed pharmacist-led home medicines reviews targeting treatable traits and their impact on health outcomes in people with chronic obstructive pulmonary disease: a pre- and post-intervention study

Sarwar,

McDonald,

Abramson

et al. 2024

Int J Clin Pharm

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Background Patients with chronic obstructive pulmonary disease (COPD) should engage in self-management strategies targeting behavioural traits and lifestyle risk-factors for optimal outcomes. Aim To evaluate the impact of credentialed pharmacist-led home medicines review (HMR) targeting treatable traits (TTs) on health outcomes in COPD in primary care. Method A pre- and post-intervention study was nested within a cluster-randomised controlled trial. A total of 81 participants with COPD from 21 Australian general practices received an HMR with a credentialed pharmacist targeting TTs. Changes in health outcomes at 6 and 12 months from baseline were assessed. Results Ten TTs were assessed and targeted during the HMR. At baseline, no-one had a written action plan for managing exacerbations, and medication adherence was sub-optimal in 85% of patients. Additionally, 53% of participants demonstrated inadequate inhaler device technique, while 52% were current smokers. At 6-months follow-up, significant improvements were observed in health-related quality of life (St. George’s Respiratory Questionnaire score = 34.6 versus 39.1 at baseline, p = 0.006), health status (COPD Assessment Test score = 12 versus 16, p = 0.002), anxiety (Hospital Anxiety and Depression Scale (HADS)–Anxiety score = 2.0 versus 5.0, p < 0.001), depression (HADS-Depression score = 1.0 versus 5.0, p < 0.001), self-reported smoking (47% versus 51.9%, p = 0.031) and treatment adherence (Tool for Adherence Behaviour Screening score = 12.5 versus 10.0, p = 0.002). At 12-months: health status, anxiety, depression, smoking abstinence and adherence to treatment, continued to show statistically significant improvements compared to baseline measurements. Conclusion HMRs targeting TTs improved health outcomes in people with COPD. Credentialed pharmacists in primary care can work alongside general practitioners to optimise COPD management.

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Evaluation of a pharmacist-led intervention to reduce drug-related problems in patients included in a home healthcare program: study protocol for a pragmatic randomized clinical trial

Salom-Garrigues,

Aragonès,

Giralt

et al. 2024

BMC Geriatr

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Background ATDOM is the Catalan home healthcare program at primary care level. Patients in the home care program are usually frail, elderly people with multiple comorbidities. They are often polymedicated, leading to a high risk of drug-related problems (DRPs). Our hypothesis is that the pharmacist-led individualized review of the pharmacotherapeutic plans of ATDOM patients will be effective in improving the quality of treatments by reducing DRPs in terms of indication, adequacy, effectiveness, and safety. Methods Aim: To compare the effectiveness of a standardized pharmaceutical intervention for the review and optimization of pharmacological treatments in ATDOM patients with usual management practice. Design: Pragmatic randomized clinical trial with a comparable control group, with prospective follow-up regarding the intervention on the adequacy of the pharmacological treatment of patients in the ATDOM program. Setting: Primary care teams in the Camp de Tarragona Primary Care Area, Tarragona, Spain. Participants: Four hundred and thirty-two ATDOM patients will be recruited, those who are over 65 years old and who are currently undergoing pharmacological treatment. Measures: Effectiveness of a six-month long intervention in reducing DRPs per patient and polypharmacy. Additionally, in the intervention group we will evaluate the implementation of the proposals for change or improvement made by the responsible physician. Analysis: The outcomes will be analyzed on an intent-to-treat basis and the analysis units will be the individual patients. Logistic regression and linear regression models will be used to evaluate the effects of the intervention on dichotomous and continuous variables versus the control arm. Ethics: The protocol was approved by the Research Ethics Committee of the Jordi Gol Primary Care Research Institute (IDIAPJGol), Barcelona, (19/141-P). Discussion If the results of the pharmaceutical intervention are favorable, widespread implementation of the program could be possible. It could be extended to all ATDOM patients or outpatients in general. Interdisciplinary teamwork could be strengthened as a result, which would improve the healthcare continuum. Trial registration Retrospectively registered. ClinicalTrials.gov Identifier NCT05820945; Registered 21 March, 2023.

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Effects of home medication review on drug-related problems and health-related quality of life among community-dwelling older adults in China

Cited by 7 publications

References 23 publications

A rapid review of interventions to improve medicine self‐management for older people living at home

A rapid review of interventions to improve medicine self‐management for older people living at home

Credentialed pharmacist-led home medicines reviews targeting treatable traits and their impact on health outcomes in people with chronic obstructive pulmonary disease: a pre- and post-intervention study

Evaluation of a pharmacist-led intervention to reduce drug-related problems in patients included in a home healthcare program: study protocol for a pragmatic randomized clinical trial

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