Evaluating the impact of general practice pharmacist-led person-centred medicines reviews on medicines appropriateness and patient-reported outcome measures.
Clare Kinahan, Ciara Kirke, Leon O'Hagan, Frank Moriarty, Kevin D Murphy, Laura J Sahm, Cian O'Mahony, Emma J Coyle, Stephen Byrne, Kieran Dalton
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引用次数: 0
Abstract
Aim: The aim of this study was to investigate the impact of pharmacist-led person-centred medicines reviews in general practices on medicines appropriateness, polypharmacy indicators (high-risk prescribing markers), and patient-reported outcome measures (PROMs).
Methods: Four pharmacists conducted person-centred medicines reviews in ten general practices between January 2021 and December 2022 for patients with hyperpolypharmacy (prescribed ≥10 regular medicines) and/or at high risk of medicines-related harm. Prescribing recommendations were provided to the general practitioner and followed up with patients and/or healthcare professionals. In this single arm study, pre and post intervention: (1) polypharmacy indicators were documented, and for a sample of patients, the (2) Person-Centred Medication Appropriateness Index (PC-MAI) scores and (3) PROMs were gathered.
Results: Of the 1471 included patients, the mean age was 76 years, 88.4% had hyperpolypharmacy, whilst the mean number of medicines was 13.8 pre and 12.3 post review. Of the 1056 polypharmacy indicator occurrences identified, 70.7% were resolved post review. Of the 194 patients with pre-review and post-review PC-MAI scores, 99% had a reduction; the mean reduction was 17.3 (95% confidence interval [CI] 15.8-18.8, P < .0001) per patient and 1.2 (95% CI 1.0-1.3, P < .0001) per medicine. PROMs were collected for 179 patients; 87.7% reported the review helped their medicines understanding, 63.1% their experience of side effects, 36.9% their ability to take medicines correctly, and 30.5% the impact of medicines on their daily activities.
Conclusions: General practice pharmacist-led person-centred medicines reviews for patients with hyperpolypharmacy and/or at high risk of medicines-related harm delivered substantial improvements in medicines appropriateness and patient-reported outcomes, thus providing evidence to support their wider implementation.
期刊介绍：
Published on behalf of the British Pharmacological Society, the British Journal of Clinical Pharmacology features papers and reports on all aspects of drug action in humans: review articles, mini review articles, original papers, commentaries, editorials and letters. The Journal enjoys a wide readership, bridging the gap between the medical profession, clinical research and the pharmaceutical industry. It also publishes research on new methods, new drugs and new approaches to treatment. The Journal is recognised as one of the leading publications in its field. It is online only, publishes open access research through its OnlineOpen programme and is published monthly.
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