Objective:To evaluate the clinical impact of a comprehensive medication management (CMM) service in a Brazilian primary health-care setting.Methods:A quasi-experimental study has been carried out between July 2014 and November 2016 with patients who received the service in the primary care setting of a Brazilian city (n = 1057). Factors associated with drug therapy problems (DTP) detection in the initial assessment were evaluated by performing univariate and multivariate analyzes. To evaluate the impact of the CMM service, a linear regression model was constructed from the difference between the initial and final values of the clinical and laboratory parameters adjusted by multiple variables.Results:A total of 1642 DTPs was identified, the most prevalent one being “nonadherence” (31.9%) and the “need for additional drug therapy” (22.9%). The use of 5 or more medications and the presence of 3 or more diseases were positively associated with the identification of 3 or more DTPs during the initial assessment. Even after multiple adjustments, a statistically significant reduction has been observed in the values of glycated hemoglobin, systolic blood pressure, low-density cholesterol, and total cholesterol.Conclusion:The CMM service contributed to the resolution of DTP and showed positive clinical impact in primary health care in the studied setting.

Objectives To assess the clinical impact of comprehensive medication management (CMM) services offered to geriatric and hypertensive patients in primary health care in Brazil. Methods A quasi-experimental study was carried out with patients followed up in primary care in three Brazilian cities (n = 346). McNemar’s test was used to assess the clinical impact of the service. Key findings A total of 1308 drug therapy problem (DTPs) were identified and 581 (44.4%) were resolved. Among the DTPs, the majority were related to non-adherence to therapy (23.9%; n = 313) or the need for additional medications (18.2%; n = 238). It was observed an increase in the proportion of people who had their blood pressure controlled at the last visit when compared with the first visit. Conclusions This study indicates that the CMM service can contribute to achieving blood pressure control in geriatric and hypertensive patients. The frequency of DTPs was high in the studied population, but many DTPs were resolved by pharmacists.

Objective: To determine the frequency of drug therapy problems among older adults in Primary Health Care, and to analyze the factors associated with their identification in the initial patient assessment, carried out by pharmacists offering medication therapy management services. Methods: A cross-sectional study conducted with data from 758 older adults followed up in medication therapy management services in Primary Health Care in the cities of Belo Horizonte, Betim, and Lagoa Santa (MG, Brazil). Univariate and multivariate analyses were performed to evaluate the factors associated with identification of four or more drug therapy problems in the initial clinical assessment. Results: A total of 1,683 drug therapy problems were identified, 73.6% of older patients had at least one problem. The most frequent problems were nonadherence (23.0%) and the need for additional drug therapy (18.0%). Polypharmacy, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, heart failure, and aged 75 years or older remained positively and statistically associated with identification of four or more drug therapy problems (p<0.05). Conclusion: There is a high frequency of problems related to medication use among older users of Primary Health Care, and the medication therapy management services should be prioritized to the older patients, who present with polypharmacy, chronic obstructive pulmonary disease, hypertension, diabetes mellitus, heart failure, and age ≥ 75 years, since they are more likely to have more drug therapy problems.

This study aims to assess the performance of pharmacy students in the provision of a comprehensive medication management (CMM) service in a primary health care setting. Methods: A retrospective, descriptive, observational study spanning one academic semester of the provision of the CMM service by pharmacy students was conducted. The data on the profile of patients attended, drug therapy-related problems (DRPs) identified, and the interventions proposed to resolve the DRPs were collected from electronic medical records held by the service. Key findings: A total of 20 patients were attended, predominantly women (65%), with a mean age of 69.2 years. The mean number of health problems per patient was 4.8 and mean medications per patient was 6.8. Of the total 35 DRPs identified, the most common were those related to indication (40%) and effectiveness (22.9%) of the drug therapy. The two most frequent interventions to resolve the DRPs involved starting new therapy and changing dosage, respectively. Conclusions: The results allowed inferences to be made about the effectiveness of pharmacy practice experience for developing clinical competencies of pharmacy students, given that the performance of students proved comparable to that of pharmacists in established CMM services reported in the literature.