1
|
Al-Maqbali JS, Al-Zakwani I. Inappropriate Polypharmacy and the Need for Comprehensive Medication Management Service. Sultan Qaboos Univ Med J 2024; 24:149-151. [PMID: 38828254 PMCID: PMC11139375 DOI: 10.18295/squmj.3.2024.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/12/2024] [Accepted: 02/29/2024] [Indexed: 06/05/2024] Open
Affiliation(s)
- Juhaina S. Al-Maqbali
- Department of Pharmacology & Clinical Pharmacy, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman; Department of Pharmacy, Sultan Qaboos University Hospital, University Medical City, Muscat, Oman
| | - Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine and Health Science, Sultan Qaboos University, Muscat, Oman; Department of Pharmacy, Sultan Qaboos University Hospital, University Medical City, Muscat, Oman
| |
Collapse
|
2
|
Tôrres LL, Azevedo PS, Rocha Sarmento TT, Ramalho-de-Oliveira D, Reis EA, Dias Godói IP, Guerra Júnior AA, Ruas CM. Acceptability and consumers' willingness to pay for comprehensive medication management services in Brazil. J Comp Eff Res 2024; 13:e230127. [PMID: 38329429 PMCID: PMC11044949 DOI: 10.57264/cer-2023-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/18/2024] [Indexed: 02/09/2024] Open
Abstract
Aim: Comprehensive medication management (CMM) is a clinical service that aims to optimize the therapeutic results of patients at the individual level. Studies carried out in Brazil and in several parts of the world have found a positive impact of the service, mainly in the resolution of drug therapy problems and in improving clinical outcomes and patients' quality of life. This service is not widespread and its acceptability and willingness to pay were not defined by the population yet. Objective: This work aims to conduct a study with users of private health services to determine the acceptability and willingness to pay for CMM services. Methods: This is a cross-sectional survey conducted through face-to-face interviews, among residents over 18 years of age of the metropolitan region of Belo Horizonte, capital of Minas Gerais State, Brazil. Results: For this study, 563 individuals were interviewed. Most respondents were female (55.1%), had completed high school (46.8%) and were employed (62.5%). The acceptability for the service was 93,25%, and among all respondents, 37 would not accept the service even if it was free. The amount of consumers' willingness to pay for the CMM service was estimated at $17.75 (40.00 BRL). Conclusion: The research results show that most people are willing to pay for the CMM service. This study can contribute to the decision-making regarding the implementation and pricing of the service in Brazil.
Collapse
Affiliation(s)
- Lucas Lima Tôrres
- Faculty of Pharmacy – Federal University of Minas Gerais, 6627 Moacir Gomes de Freitas St., Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Pâmela Santos Azevedo
- Postgraduate Program in Medicines & Pharmaceutical Assistance, School of Pharmacy, Federal University of Minas Gerais, 6627 Moacir Gomes de Freitas St., Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Túlio Tadeu Rocha Sarmento
- Faculty of Pharmacy – Federal University of Minas Gerais, 6627 Moacir Gomes de Freitas St., Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Djenane Ramalho-de-Oliveira
- Faculty of Pharmacy – Federal University of Minas Gerais, 6627 Moacir Gomes de Freitas St., Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Edna Afonso Reis
- Statistics Department – Federal University of Minas Gerais, 308 Reitor Pires Albuquerque St., Pampulha, Belo Horizonte, Minas Gerais, 31270-010, Brazil
| | - Isabella Piassi Dias Godói
- Institute of Pharmaceutical Sciences, Federal University of Rio de Janeiro, Avenida Aluízio da Silva Gomes 50, Granja dos Cavaleiros, Macaé, Rio de Janeiro, 27930-560, Brazil
- Health Technology Assessment Center - Management, Economics, Education and Pharmaceutical Services, Federal University of Rio de Janeiro, Avenida Aluízio da Silva Gomes 50, Granja dos Cavaleiros, Macaé, Rio de Janeiro, 27930-560, Brazil
| | - Augusto Afonso Guerra Júnior
- Faculty of Pharmacy – Federal University of Minas Gerais, 6627 Moacir Gomes de Freitas St., Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
- Collaborating Center of the SUS for Technology Assessment & Excellence in Health, School of Pharmacy, Federal University of Minas Gerais, 6627 Moacir Gomes de Freitas St., Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| | - Cristina Mariano Ruas
- Faculty of Pharmacy – Federal University of Minas Gerais, 6627 Moacir Gomes de Freitas St., Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil
| |
Collapse
|
3
|
Brajković A, Bićanić LA, Orehovački H, Prkačin I, Oliveira DRD, Mucalo I. Prescribers' approval rate of pharmacist-initiated interventions to optimise patients' clinical status of hypertension in the ambulatory care setting. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2023; 73:723-734. [PMID: 38147475 DOI: 10.2478/acph-2023-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 12/28/2023]
Abstract
This perspective, pre- and post-intervention study with a one-year follow-up primarily aimed to ascertain prescribers' approval rate of pharmacists' interventions and clinical status of hypertension following comprehensive medication management (CMM) intervention in the ambulatory care clinic. Between January 2018 and January 2022 overall 100 patients with hypertension and other comorbidities were referred to the CMM services at the Health Centre Zagreb - Centar (HCZC). Out of 275 interventions directed to prescribers, 73.1 % of interventions were approved, 12.4 % were rejected and 14.5 % were not reviewed. The percentage of patients with a blood pressure goal increased from 45 % at the initial consultation to 82.5 % at the patients' latest encounter (p < 0.001). The average number of drug therapy problems (DTPs) per patient totaled 3.53 ± 1.80, where 98 % of patients had one or more DTPs, 48 % had 4 or more DTPs, whereas 26 % had 5 or more DTPs. Sub-therapeutic dosage (32.6 %) and the need for additional drug therapy (30.9 %) were the two most commonly identified DTPs. These results reinforce the need to integrate pharmacy-led services in the primary care setting with the aim of improving patients' health outcomes.
Collapse
Affiliation(s)
- Andrea Brajković
- 1University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb Croatia
| | | | | | - Ingrid Prkačin
- 3Department of Internal Medicine School of Medicine, University of Zagreb, Merkur University Hospital Zagreb, Croatia
| | - Djenane Ramalho De Oliveira
- 4College of Pharmacy, Centre for Pharmaceutical Care Studies, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Iva Mucalo
- 1University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb Croatia
| |
Collapse
|
4
|
Moreira PM, Aguiar EC, Castro PR, Almeida KC, Dourado JA, Paula SM, Melo MF, Santos PM, Oliveira MG. Optimizing Hypertension Treatment in Older Patients Through Home Blood Pressure Monitoring by Pharmacists in Primary Care: The MINOR Clinical Trial. Clin Ther 2023; 45:941-946. [PMID: 37365046 DOI: 10.1016/j.clinthera.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/29/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE Incorporating technology such as home blood pressure monitoring (HBPM) into the clinical routine generates opportunities to improve BP monitoring and control in primary health care. It is also important to prevent overtreatment. However, the combination of HBPM with collaborative drug therapy management (CDTM) has not yet been studied. This study aimed to assess the efficacy of combining HBPM with CDTM to optimize hypertension treatment for older patients. METHODS This open-label, parallel-group, randomized clinical trial was conducted between June 2021 and August 2022 in a Brazilian community pharmacy and included older patients (aged ≥60 years) with hypertension. Those who were classified as poorly adherent or nonadherent to the prescribed drug treatment or who were unable to perform HBPM were excluded. In the control group, participants received a BP monitor and instructions on how to perform HBPM. A general practitioner, who was provided a report with the obtained BP values, determined any changes to the treatment protocol. In the intervention group, a pharmacist enrolled participants in a drug therapy management protocol and provided the general practitioner with suggestions to optimize the antihypertensive drug therapy, in addition to the report with the BP values. The following outcomes were considered: the proportion of participants receiving deprescriptions of antihypertensive drugs, other treatment adjustments, and the difference in mean BP between the groups 45 days after performing HBPM. The study used a t test combined with Levene's test to calculate mean intergroup differences in BP, the paired t test to calculate mean intragroup differences in BP, and Pearson's χ2 test to determine intergroup differences in changes in drug therapy. FINDINGS In each group, 161 participants completed the trial. Antihypertensive agents were deprescribed for 31 (19.3%) participants in the intervention group versus 11 (6.8%) in the control group (P = 0.01). In addition, 14 (8.7%) participants were prescribed antihypertensive drugs in the intervention group versus 11 (6.8%) in the control group (P = 0.52). The mean office systolic BP and HBPM values were lower in the intervention group (P = 0.22 and P = 0.29, respectively). IMPLICATIONS Combining HBPM with a CDTM protocol effectively optimized antihypertensive treatment for older patients in a primary health care setting. CLINICALTRIALS gov identifier: NCT04861727.
Collapse
Affiliation(s)
- Pablo Maciel Moreira
- Programa de Pós-Graduação em Saúde Coletiva, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Candeias, Vitória da Conquista, Brazil
| | - Erlan Canguçu Aguiar
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Candeias, Vitória da Conquista, Brazil; Programa de Pós-Graduação em Assistência Farmacêutica em Rede e Associação de Instituições de Ensino Superior, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brazil
| | - Priscila Ribeiro Castro
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Candeias, Vitória da Conquista, Brazil
| | - Kleiton Coelho Almeida
- Programa de Pós-Graduação em Assistência Farmacêutica em Rede e Associação de Instituições de Ensino Superior, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brazil
| | - July Anne Dourado
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Candeias, Vitória da Conquista, Brazil
| | - Sabrina Miranda Paula
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Candeias, Vitória da Conquista, Brazil
| | - Milena Flores Melo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Candeias, Vitória da Conquista, Brazil
| | - Pablo Moura Santos
- Programa de Pós-Graduação em Assistência Farmacêutica em Rede e Associação de Instituições de Ensino Superior, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brazil
| | - Marcio Galvão Oliveira
- Programa de Pós-Graduação em Saúde Coletiva, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Candeias, Vitória da Conquista, Brazil; Programa de Pós-Graduação em Assistência Farmacêutica em Rede e Associação de Instituições de Ensino Superior, Faculdade de Farmácia, Universidade Federal da Bahia, Salvador, Brazil.
| |
Collapse
|
5
|
Orehovački H, Brajković A, Bićanić LA, Mucalo I. Polypharmacy - is there a cure for drug therapy problems? Croat Med J 2023; 64:295-300. [PMID: 37654043 PMCID: PMC10509682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Affiliation(s)
| | - Andrea Brajković
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | | | - Iva Mucalo
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
6
|
Orehovački H, Brajković A, Bićanić LA, Mucalo I. Polypharmacy - is there a cure for drug therapy problems? Croat Med J 2023; 64:295-300. [PMID: 37654043 PMCID: PMC10509682 DOI: 10.3325/cmj.2023.64.295] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Affiliation(s)
| | - Andrea Brajković
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | | | - Iva Mucalo
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| |
Collapse
|
7
|
Urbańczyk K, Guntschnig S, Antoniadis V, Falamic S, Kovacevic T, Kurczewska-Michalak M, Miljković B, Olearova A, Sviestina I, Szucs A, Tachkov K, Tiszai Z, Volmer D, Wiela-Hojeńska A, Fialova D, Vlcek J, Stuhec M, Hogg A, Scott M, Stewart D, Mair A, Ravera S, Lery FX, Kardas P. Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes. Front Pharmacol 2023; 14:1244151. [PMID: 37601045 PMCID: PMC10433912 DOI: 10.3389/fphar.2023.1244151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
Clinical pharmacy as an area of practice, education and research started developing around the 1960s when pharmacists across the globe gradually identified the need to focus more on ensuring the appropriate use of medicines to improve patient outcomes rather than being engaged in manufacturing and supply. Since that time numerous studies have shown the positive impact of clinical pharmacy services (CPS). The need for wider adoption of CPS worldwide becomes urgent, as the global population ages, and the prevalence of polypharmacy as well as shortage of healthcare professionals is rising. At the same time, there is great pressure to provide both high-quality and cost-effective health services. All these challenges urgently require the adoption of a new paradigm of healthcare system architecture. One of the most appropriate answers to these challenges is to increase the utilization of the potential of highly educated and skilled professionals widely available in these countries, i.e., pharmacists, who are well positioned to prevent and manage drug-related problems together with ensuring safe and effective use of medications with further care relating to medication adherence. Unfortunately, CPS are still underdeveloped and underutilized in some parts of Europe, namely, in most of the Central and Eastern European (CEE) countries. This paper reviews current situation of CPS development in CEE countries and the prospects for the future of CPS in that region.
Collapse
Affiliation(s)
- Kamila Urbańczyk
- Department of Clinical Pharmacology, Wroclaw Medical University, Wroclaw, Poland
- Regional Specialist Hospital in Wroclaw, Wroclaw, Poland
| | - Sonja Guntschnig
- Tauernklinikum Zell am See, Zell am See, Austria
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Coleraine, Northern Ireland
| | | | - Slaven Falamic
- Department of Pharmacokinetics and Clinical Pharmacy, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | - Tijana Kovacevic
- Pharmacy Department, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
- Department of Pharmacokinetics and Clinical Pharmacy, Faculty of Medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | | | - Branislava Miljković
- Department of Pharmacokinetics and Clinical Pharmacy, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Anna Olearova
- Department of Clinical Pharmacology, University Hospital Bratislava—Hospital Ruzinov, Bratislava, Slovakia
| | - Inese Sviestina
- Faculty of Medicine, University of Latvia, Riga, Latvia
- Children’s Clinical University Hospital, Riga, Latvia
| | - Attila Szucs
- Pharmacy Department, National Institute of Oncology, Budapest, Hungary
| | - Konstantin Tachkov
- Department of Organization and Economy of Pharmacy, Faculty of Pharmacy, Medical University-Sofia, Sofia, Bulgaria
| | - Zita Tiszai
- Department of Hospital Pharmacy, Bajcsy-Zsilinszky Hospital, Budapest, Hungary
| | - Daisy Volmer
- Institute of Pharmacy, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Anna Wiela-Hojeńska
- Department of Clinical Pharmacology, Wroclaw Medical University, Wroclaw, Poland
| | - Daniela Fialova
- Department of Clinical and Social Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia
- Department of Geriatrics and Gerontology, First Faculty of Medicine in Prague, Charles University, Prague, Czechia
| | - Jiri Vlcek
- Department of Clinical and Social Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia
- Clinical Pharmacy Department, Hospital Pharmacy, Teaching Hospital Hradec Kralove, Hradec Králové, Czechia
| | - Matej Stuhec
- Department of Pharmacology, Faculty of Medicine Maribor, University of Maribor, Maribor, Slovenia
- Department of Clinical Pharmacy, Ormoz Psychiatric Hospital, Ormoz, Slovenia
| | - Anita Hogg
- Medicines Optimisation Innovation Centre, Antrim Hospital, Antrim, United Kingdom
| | - Michael Scott
- Medicines Optimisation Innovation Centre, Antrim Hospital, Antrim, United Kingdom
| | - Derek Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
- European Society of Clinical Pharmacy, Leiden, Netherlands
| | - Alpana Mair
- Effective Prescribing and Therapeutics, Health and Social Care Directorate, Scottish Government, Edinburgh, United Kingdom
| | - Silvia Ravera
- European Directorate for the Quality of Medicines & Healthcare, Council of Europe, Strasbourg, France
| | - François-Xavier Lery
- European Directorate for the Quality of Medicines & Healthcare, Council of Europe, Strasbourg, France
| | - Przemysław Kardas
- Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| |
Collapse
|
8
|
Comprehensive Medication Management Services with a Holistic Point of View, a Scoping Review. PHARMACY 2023; 11:pharmacy11010037. [PMID: 36827675 PMCID: PMC9964776 DOI: 10.3390/pharmacy11010037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023] Open
Abstract
Implementing Comprehensive Medication Management (CMM) services uncovered the importance of the totality of the patient's perspective in this process. The holistic approach takes into account the physical, mental and emotional well-being of individuals, as well as their socioeconomic circumstances. The aim of this study was to characterize the scientific evidence associated with CMM services that included this holistic approach. A scoping review was conducted based on Arksey and O'Malley's method. Searches were performed in Google Scholar for papers published between 2010 and 2020 in English, Spanish and Portuguese. Study design, health contexts, sample of patients, results obtained, barriers and facilitators, and the integration of a holistic approach were determined. Two hundred and eighteen papers were evaluated, most of which focused on the implementation of this service through prospective observational studies. A minority of studies reported on a holistic approach, a smaller number examined the effect of social determinants of health, the patient's medication experiences and the pharmacotherapy outcomes from the patient's perspective. Despite the progress achieved, most of the referents do not yet reflect a broader view of the patient's life situation and its relationship to pharmacotherapy and the ways in which the pharmacist implements holistic elements to solve or prevent drug-related problems.
Collapse
|
9
|
Schaffer AL, Chia J, Brett J, Pearson S, Falster MO. A nationwide study of multimedicine use in people treated with cardiovascular medicines in Australia. Pharmacotherapy 2022; 42:828-836. [PMID: 36239072 PMCID: PMC9828398 DOI: 10.1002/phar.2735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE Multimorbidity and multimedicine use are common in people with cardiovascular disease and can lead to harms, such as prescribing errors and drug interactions. We quantified multimedicine use in people treated with cardiovascular medicines in a national sample of Australians. DESIGN Cross-sectional study. DATA SOURCE Pharmaceutical dispensing claims for a 10% random sample of Australians. PATIENTS Australian adults dispensed any cardiovascular medicine between June and August 2019. INTERVENTION None. MEASUREMENTS We quantified the number and type of cardiovascular and non-cardiovascular medicines dispensed during the study period, and the number of unique prescribers, by age and sex. MAIN RESULTS We identified 493,081 people dispensed any cardiovascular medicine (median age = 67 years, 50.2% women). The population prevalence of cardiovascular medicine dispensing increased from 1.7% (n = 10,503) in people 18-34 years to 80.1% (n = 99,271) in people 75-84 years. Cardiovascular medicine dispensing varied by sex; women 18-34 years were more likely to be dispensed any cardiovascular medicine than men (male:female prevalence ratio [PR] = 0.84, 95% confidence interval [CI] = 0.81-0.87), whereas the prevalence of cardiovascular medicine dispensing was higher in men 35-44 years (PR = 1.27, 95% CI 1.24-1.30) and 45-54 years (PR = 1.24, 95% CI 1.22-1.26) and was similar between sexes in people ≥65 years. Overall, both women and men were dispensed a median of 2.0 (interquartile range [IQR] = 1.0-3.0) cardiovascular medicines. Two-thirds of people ≥65 years (73.5%; n = 208,524) were dispensed ≥2 cardiovascular medicines, with 16.6% (n = 6736) of people ≥85 years dispensed five or more. Women and men were dispensed a median of 2.0 (IQR = 1.0-5.0) and 2.0 (IQR = 0.0-4.0) non-cardiovascular medicines, respectively, to treat comorbid conditions, commonly gastroesophageal reflux disease medicines (32.2% of women and 26.6% of men), antibiotics (28.7% of women and 22.4% of men), and antidepressants (26.3% of women and 15.9% of men). One quarter of both sexes had multiple prescribers for their cardiovascular medicines alone, whereas 54.5% (n = 134,939) of women and 49.9% (n = 122,706) of men had multiple prescribers for all medicines. CONCLUSION Multimedicine use is common in people treated with cardiovascular medicines and presents a risk for inappropriate prescribing. Understanding the comorbid conditions commonly treated concurrently with cardiovascular disease can help improve co-prescribing guidelines and develop a person-centered approach to multimorbidity treatment.
Collapse
Affiliation(s)
- Andrea L. Schaffer
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia
| | - Joel Chia
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia
| | - Jonathan Brett
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia,St Vincent's Clinical SchoolUNSW SydneySydneyNew South WalesAustralia
| | - Sallie‐Anne Pearson
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia,Menzies Centre for Health PolicyThe University of SydneySydneyNew South WalesAustralia
| | - Michael O. Falster
- Centre for Big Data Research in HealthUNSW SydneySydneyNew South WalesAustralia
| |
Collapse
|
10
|
Deng ZJ, Ding YF, Peng SS, Wang L, Wei AH. Multiple beneficial outcomes of medication therapy management interventions in randomized control trials and non-randomized control trials: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31491. [PMID: 36316852 PMCID: PMC9622691 DOI: 10.1097/md.0000000000031491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Medication therapy management (MTM) service is an effective method to reduce medication-related problems and improve patients' multiple kinds of outcomes. However, the lack of comprehensive review for MTM services has hindered its development. As a result, we are aiming to evaluate the current benefits of MTM services with multiple outcomes. METHOD An electronic search will be performed for randomized controlled trials (RCTs) or non-randomized control trials (NRCTs) that reported MTM services or pharmaceutical services as interventions from PubMed, The Cochrane Library, Embase, and ClinicalTrial. gov. The odds ratios, mean differences, and standard mean differences and their 95% confidence intervals (95% confidence intervals) will be calculated with fixed or random effect models. RESULTS This study will evaluate the multiple benefits of MTM services in clinical endpoints, quality of life, economy, and drug-related problems. CONCLUSION The results will review eligible studies released in the past twenty years and provide more comprehensive evidence of the efficacy of MTM services. ETHICS AND DISSEMINATION Ethical approval is not applicable for this study.
Collapse
Affiliation(s)
- Zhi-Jie Deng
- Department of Pharmacy, Tongji Hospital, Tongji medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu-Feng Ding
- Department of Pharmacy, Tongji Hospital, Tongji medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shun-Shun Peng
- Department of Pharmacy, Tongji Hospital, Tongji medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lu Wang
- Department of Pharmacy, Tongji Hospital, Tongji medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An-Hua Wei
- Department of Pharmacy, Tongji Hospital, Tongji medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: An-Hua Wei, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China (e-mail: )
| |
Collapse
|
11
|
Brajković A, Bićanić LA, Strgačić M, Orehovački H, Ramalho-de-Oliveira D, Mucalo I. The Impact of Pharmacist-Led Medication Management Services on the Quality of Life and Adverse Drug Reaction Occurrence. PHARMACY 2022; 10:pharmacy10050102. [PMID: 36136835 PMCID: PMC9498323 DOI: 10.3390/pharmacy10050102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022] Open
Abstract
The aim of this research was to assess the impact of comprehensive medication management (CMM) services on patients’ health-related quality of life (HRQoL) and frequency of adverse drug reactions (ADRs) in older patients with cardiovascular diseases (CVDs). A prospective, pre- and post-intervention study with a one-year follow-up was conducted at the Health Care Centre Zagreb—Centre (HCZC). The Euro-Quality of Life Questionnaire 5 Dimensions 5 Levels (EQ-5D-5L) was used to measure the HRQoL at baseline (initial visit at the HCZC) and 12 months following CMM services. The ADRs collected at the initial assessment of the CMM services and throughout follow-up consultations were analyzed according to the occurrence mechanism, seriousness, expectedness and distribution of the Preferred Term according to the System Organ Class. Following the CMM intervention, 65 patients reported significant improvement in dimensions “self-care” (p = 0.011) and “usual activities” (p = 0.003), whereas no significant change was found in the “mobility” (p = 0.203), “pain/discomfort” (p = 0.173) and “anxiety/depression” (p = 0.083) dimensions and the self-rated VAS scale (p = 0.781). A total of 596 suspected ADR reports were found, the majority at patients’ initial assessment (67.3%), with a mean ± SD of 9.2 ± 16.9 per patient. The CMM services significantly reduced the rate of suspected ADRs, namely 2.7 ± 1.7 ADRs per patient at the initial assessment vs. 1.0 ± 1.5 ADRs per patient at the last consultation (p < 0.001). The obtained results indicate that CMM services may improve patients’ HRQoL. Additionally, as CMM services diminished the proportion of ADRs following 1-year patient follow-up, they may serve as a viable solution for safety management.
Collapse
Affiliation(s)
- Andrea Brajković
- Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Lucija Ana Bićanić
- Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Marija Strgačić
- Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | | | - Djenane Ramalho-de-Oliveira
- Centre for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Iva Mucalo
- Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
- Correspondence:
| |
Collapse
|