Impact of Medication Review by Community Pharmacists

NCT05297461 | Completed

• 1 other identifier: MedRev
• Study Type: interventional
• Target: 27
• Locations: 1 country
• Sites: 1

Brief Summary

The aging population size has been enlarging globally. A higher number of older adults means a higher number of medication use. It is estimated that older adults are the largest medication consumers.That would result in various medication use problems which provide a link between polypharmacy, inappropriate medication, and deprescribing.\[2\] Primary health care providers especially community pharmacists are often the first point of healthcare towards older adults.\[3\] Various interventions are being carried out by community pharmacies to determine an optimal outcome on medication usage. Medication review intervention is a clinical process where a pharmacist reviews a patient's medication, identifies any drug-related problems and suggests strategies to reduce the medication use problems. Medication review is being utilized in various countries especially in Organisation for Economic Co-operation and Development (OECD )regions ie Australia, New Zealand, the United Kingdom, and the United States of America, and the pharmacist were remunerated for the service. Although medication review is widely searched intervention globally, the scope for intervention is lacking in low and middle-income countries. Community pharmacy is regarded as the first point of care of primary health care in a community for older adults. A systemic review search on community pharmacist-led intervention among the aging population has demonstrated medication adherence improvement outcomes. Consequently, community pharmacists can reduce medication use problems in different settings in the community in various ways and contribute to the patients' overall well-being and health-related quality of life. There is a lack of information in Malaysia due to the fragmented health care system where there is no continuity of care between the public and private sectors. During this pandemic outbreak, when most countries suffer critical health care points, much effort and pharmaceutical care should be delivered towards older adults to reduce the current burden. This study assesses the feasibility of medication review for older adults at the community pharmacy level and identifies any medication-related problems in Penang state. The significance of this study is improving medication use among older adults at a primary care level and will probably upgrade the quality of the Malaysian health care system by providing some program and policy level solutions towards the problems.

Conditions

Aging

Outcome Measures

Primary Outcomes (4)

• Assessing feasibility: intervention time

  Length of intervention (minutes)

  6 months

• Assessing feasibility: Number of staffs

  Number of staffs

  6 months

• Assessing feasibility: Access to prescribers

  Number of prescribers contacted

  6 months

• Type and number medication-related problem

  1. Number of inappropriate medications (Based on Beer's criteria) 2. Number of medications 3. Adverse drug reactions detected 4. Drug-drug interaction 5. Improper medication administration 6. Incorrect dose and frequency of medications

  6 months

Study Arms (2)

Medication Review

EXPERIMENTAL

The intervention group will receive medication review intervention which includes reviewing older adults' medications and identifying any drug-related problems.

Other: Medication review

Standard Care

NO INTERVENTION

The standard care includes the current existing care provided to patients in the community pharmacy.

Interventions

Medication review OTHER

Community pharmacy benchmarking guideline Pharmaceutical Services Division provides guidelines for medication review in community pharmacy settings in Malaysia

Medication Review

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients above 60 years old Patients who have chronic disease ie diabetes, hypertension, cardiovascular
• Patients who have been patronizing the pharmacy for the purchase of at least one prescription medication for the past three months.
• Patients be able to converse, read and understand the Malay language or English language.
• Access to a telephone or mobile phone or internet
• The patients must understand the study process, agree to participate in this study, and sign the informed consent

You may not qualify if:

• Patient who are unable to converse, read and understand Malay or English language
• Patients who unable to give their consent

Sponsors & Collaborators

• Monash University Malaysia: lead

Study Sites (1)

Northern MCPG

George Town, Pulau Pinang, Malaysia

Location

Related Publications (9)

• Marek KD, Antle L. Medication Management of the Community-Dwelling Older Adult. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 18. Available from http://www.ncbi.nlm.nih.gov/books/NBK2670/

  PMID: 21328769 BACKGROUND

• Mangin D, Garfinkel D. Foreword to the first special collection: Addressing the invisible iatrogenic epidemic: the role of deprescribing in polypharmacy and inappropriate medication use. Ther Adv Drug Saf. 2019 Oct 21;10:2042098619883156. doi: 10.1177/2042098619883156. eCollection 2019. No abstract available.

  PMID: 31673327 BACKGROUND

• Ramli A, Taher S. Managing chronic diseases in the malaysian primary health care - a need for change. Malays Fam Physician. 2008 Apr 30;3(1):7-13. eCollection 2008.

  PMID: 25606105 BACKGROUND

• Blenkinsopp A, Bond C, Raynor DK. Medication reviews. Br J Clin Pharmacol. 2012 Oct;74(4):573-80. doi: 10.1111/j.1365-2125.2012.04331.x.

  PMID: 22607195 BACKGROUND

• Lee E, Braund R, Tordoff J. Examining the first year of Medicines Use Review services provided by pharmacists in New Zealand: 2008. N Z Med J. 2009 Apr 24;122(1293):3566.

  PMID: 19448788 BACKGROUND

• Ramalho de Oliveira D, Brummel AR, Miller DB. Medication therapy management: 10 years of experience in a large integrated health care system. J Manag Care Pharm. 2010 Apr;16(3):185-95. doi: 10.18553/jmcp.2010.16.3.185.

  PMID: 20331323 BACKGROUND

• Benrimoj SI, Roberts AS. Providing patient care in community pharmacies in Australia. Ann Pharmacother. 2005 Nov;39(11):1911-7. doi: 10.1345/aph.1G165. Epub 2005 Oct 11.

  PMID: 16219897 BACKGROUND

• Beuscart JB, Petit S, Gautier S, Wierre P, Balcaen T, Lefebvre JM, Kambia N, Bertoux E, Mascaut D, Barthelemy C, Cuny D, Puisieux F, Decaudin B. Polypharmacy in older patients: identifying the need for support by a community pharmacist. BMC Geriatr. 2019 Oct 21;19(1):277. doi: 10.1186/s12877-019-1276-y.

  PMID: 31638909 BACKGROUND

• Christopher CM, Blebil AQ, Bhuvan KC, Alex D, Ibrahim MIM, Ismail N, Cheong MWL. Assessing feasibility of conducting medication review with follow-up among older adults at community pharmacy: a pilot randomised controlled trial. Int J Clin Pharm. 2024 Aug;46(4):843-853. doi: 10.1007/s11096-024-01711-3. Epub 2024 Apr 18.

  PMID: 38635115 DERIVED

MeSH Terms

Interventions

Medication Review

Intervention Hierarchy (Ancestors)

Medication Systems; Organization and Administration; Health Services Administration; Patient Care Management

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: March 17, 2022
• First Posted: March 28, 2022
• Study Start: June 30, 2022
• Primary Completion: November 30, 2022
• Study Completion: January 30, 2023
• Last Updated: October 31, 2023

Record last verified: 2023-10

Locations

MY (1)