Pharmacist‐led interventions to improve medication adherence in older adults: A <scp>meta‐analysis</scp>

Marcum, Zachary A.; Jiang, Shangqing; Bacci, Jennifer L.; Ruppar, Todd

doi:10.1111/jgs.17373

Cited by 21 publications

(18 citation statements)

References 71 publications

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“…12 A systematic review reported that pharmacists' interventions improved patients' adherence. [26][27][28] Furthermore, a systematic review of 29 studies that used text messages to improve adherence found efficacy in interventions that used motivational messages. 29 Therefore, for Asian patients, more aggressive interventions are needed by pharmacists for preoperative discontinuation of medications.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Non-Adherence to Medications That Affect Surgery: A Retrospective Study in Japan

Akamine¹,

Nagasaki²,

Tomizawa³

et al. 2022

PPA

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Data on risk factors for non-adherence to doctors' and pharmacists' instructions to discontinue medications prior to surgery are lacking. This study aimed to identify characteristics and risk factors for such non-adherent patients. Patients and Methods: Data (including patient age, sex, prescription medications, comorbidities, presence of roommate at home, and number of days between receiving instruction and surgery) of 887 patients who used medications affecting surgery at a university hospital from April 2017 to March 2020 were retrospectively evaluated. The primary endpoint was to investigate the rate of non-adherence and to explore independent risk factors for non-adherence (with age categorized as ≥65 [versus <65] years). Secondary endpoints included analysis of limited number of departments subgroup and a sensitivity analysis (with age categorized as ≥75 [versus <75] years) to confirm the robustness of the primary endpoint results. Independent risk factors for non-adherence were identified using logistic regression analysis. Results:The non-adherence rate was 11.4% (n=101/887), median age (interquartile range) at admission was 73 (70-79) years, and proportion of male patients was 81.2% (n=82). The main analysis adjusted for age ≥65 (versus <65) years showed age as a risk factor for increased nonadherence (adjusted odds ratio: 2.1, 95% confidence interval: 1.09-4.05; p=0.027). However, analyses adjusted for departments (other than urology, gynecology, and breast surgery, with a large sex bias in hospitalized patients) and for age ≥75 (versus <75) years showed no such risk. Conclusion: Age ≥65 years was associated with a higher risk of non-adherence to medications that should be discontinued before surgery. It is important for doctors and pharmacists to ensure that patients at high risk for non-adherence are aware of the importance of adherence. Our findings may help identify patients at high risk for non-adherence to such medications.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Non-Adherence to Medications That Affect Surgery: A Retrospective Study in Japan

Akamine¹,

Nagasaki²,

Tomizawa³

et al. 2022

PPA

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“…At present, few studies have evaluated the effect of medication reconciliation on patient adherence across countries; those that have done so were rated as having a low certainty of the evidence [ 31 ]. A previous meta-analysis showed that pharmacist-led interventions, especially patient education, were found to have effect on improving medication adherence in older adults [ 32 ]. Thus, the improvement we observed in patient adherence may be attributable to patient counselling and education contained in the medication reconciliation intervention.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of pharmacist-led medication reconciliation at county hospitals in China: A multicentre, open-label, assessor-blinded, nonrandomised controlled study

Fu,

Zhu,

Wei

et al. 2024

J Glob Health

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Background Due to a lack of related research, we aimed to determine the effectiveness of a pharmacist-led medication reconciliation intervention in China. Methods We conducted a multicentre, prospective, open-label, assessor-blinded, cluster, nonrandomised controlled study at six county-level hospitals, with hospital wards serving as the clusters. We included patients discharged from the sampled hospitals who were aged ≥60 years; had ≥1 studied diagnoses; and were prescribed with ≥3 medications at discharge. Patients in the intervention group received a pharmacist-led medication reconciliation intervention and those in the control group received standard care. We assessed the incidence of medication discrepancies at discharge, patients’ medication adherence, and health care utilisation within 30 days after discharge. Results There were 429 patients in the intervention group (mean age = 72.5 years, standard deviation (SD) = 7.0) and 526 patients in the control group (mean age = 73.6 years, SD = 7.1). Of the 1632 medication discrepancies identified at discharge, fewer occurred in the intervention group (1.9 per patient on average) than the control group (2.6 per patient on average).The intervention significantly reduced the incidence of medication discrepancy by 9.6% (95% confidence interval (CI) = −15.6, −3.6, P = 0.002) and improved patients’ medication adherence, with an absolute decrease in the mean adherence score of 2.5 (95% CI = −2.8, −2.2, P < 0.001). There was no significant difference in readmission rates between the intervention and control groups. Conclusions Pharmacist-led medication reconciliation at discharge from Chinese county-level hospitals reduced medication discrepancies and improved patients’ adherence among patients aged 60 years or above, though no impact on readmission after discharge was observed. Registration ChiCTR2100045668.

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“…It has also been shown to lower or avert the increase of disease-related medical costs. [1][2][3][4][5][6][7] Nonetheless, and particularly as regards cardiovascular disease, adherence to medications remains a major challenge, with nonadherence leading to poor clinical outcomes, rehospitalizations, subsequent myocardial infarction, and increased mortality. 8 Contributing factors to sub-optimal adherence include patient-related and treatment-related factors.…”

Section: Introductionmentioning

confidence: 99%

“…6,19 To address this persistent challenge of nonadherence, the literature reports on several pharmacist-led interventions that have shown a positive impact on patients' adherence to medication and clinical outcomes. 4,5,20,21 For instance, enrollment in a medication adherence program in community pharmacies in New Zealand improved adherence, with individuals in the intervention group having 2.99 (95% CI: 2.79-3.20) greater odds of being adherent 12 months after the start of the study. 20 Elsewhere, patients were telephoned by pharmacists monthly to assess changes in adherence to medication for diabetes, hypertension, or hyperlipidemia therapies over 6 months.…”

Section: Introductionmentioning

confidence: 99%

Assessing a Pharmacist-Enabled Intervention to Improve Adherence to Medication for Hypertension, Dyslipidemia, and Chronic Venous Circulation Disorders in Greece

Golna,

Poimenidou,

Giannoukari

et al. 2023

PPA

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Background: Adherence to medication in chronic conditions may be influenced by interventions from pharmacists. This study aimed to assess the impact of guidance and reminders from pharmacists on adherence to medication for hypertension, dyslipidemia, and chronic venous circulation disorders (CVCD) in Greece. Methods:The prospective CONCORD study aimed to record and report on change in self-reported adherence to medication following pharmacist reminders amongst a cohort of adult patients, diagnosed with at least one or a combination of these health conditions. All study participants were regular patients of a network of pharmacies in Attica and southern Greece. Pharmacists were trained to provide adherence reminders over 4 months. Impact on self-reported adherence of the intervention was reported at baseline and again in month 4. Results: Of the 1146 participants, 48% were men and 60% were aged 55-74 years. Among them, 23.7% were diagnosed with hypertension, 16.5% with dyslipidemia, 3% with CVCD, 42.5% with hypertension and dyslipidemia, 3.1% with hypertension and CVCD, 2.6% with dyslipidemia and CVCD, and 8.6% with dyslipidemia, hypertension, and CVCD. In month 4 vs month 0, patients were less likely to forget to take their prescribed medications (p<0.001), to be careless about their medications during the last 30 days (p<0.001), and to temporarily discontinue their medications without prior doctor's advice (p<0.001). Patients with CVCD were more prone to lower self-reported adherence compared to patients who were not diagnosed with CVCD or a combination of conditions that included CVCD. Discussion: Reminders and advice from pharmacists resulted in higher adherence to medication amongst participants in month 4 versus month 0. Conclusion: Pharmacist-enabled interventions, including reminders and advice, following targeted training, may positively impact on patient medication adherence in chronic health conditions.Plain Language Summary: This study aimed to measure the impact of reminders and advice on adherence to medication provided by private pharmacists to patients with hypertension, dyslipidemia, and/or chronic venous circulation disorders (CVCD) in Greece.Patients were asked to self-report adherence to medication at months 0 and 4, following advice and reminders received from trained pharmacists. Self-reported adherence was significantly improved at month 4 vs month 0 across our sample. Our study showed that pharmacist-enabled interventions, following targeted training, can quickly and significantly improve adherence to medication in patients with chronic diseases in Greece.

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Pharmacist‐led interventions to improve medication adherence in older adults: A meta‐analysis

Cited by 21 publications

References 71 publications

Risk Factors for Non-Adherence to Medications That Affect Surgery: A Retrospective Study in Japan

Risk Factors for Non-Adherence to Medications That Affect Surgery: A Retrospective Study in Japan

Evaluation of pharmacist-led medication reconciliation at county hospitals in China: A multicentre, open-label, assessor-blinded, nonrandomised controlled study

Assessing a Pharmacist-Enabled Intervention to Improve Adherence to Medication for Hypertension, Dyslipidemia, and Chronic Venous Circulation Disorders in Greece

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