Value of a Community‐Based Medication Management Review Service in Jordan: A Prospective Randomized Controlled Study

J Pharm Health Serv Res

Rizik

Bulatova

2018

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Objectives Treatment‐related problems (TRPs) are of a major concern to healthcare professionals and patients. This led to the emergence of the home medication management review (HMMR) service. The aim of this study was to assess the impact of HMMR service on the number and types of TRPs for outpatients, and the effect of resolving the identified TRPs on the health outcomes of the patients. Methods The HMMR service was delivered by a clinical pharmacist over three months in 2014. Patients with chronic diseases visiting community pharmacies in Jordan were recruited and randomized into intervention and control groups. Patients’ data were collected via home visit. TRPs were identified and, for the intervention group only, education was delivered to patients and recommendations were submitted to their physicians. Three months following intervention, all patients were assessed for their TRPs, adherence and self‐care activities. Key findings Participants had a mean age of 53.01 ± 10.39. No significant differences (P > 0.05) between the intervention (n = 42) and control groups (n = 42) were found at baseline with regard to demographics, mean number (±SD) of TRPs per patient (2.81 ± 1.70 versus 2.43 ± 1.50), adherence mean score (1.81 ± 2.90 versus 2.05 ± 2.80) and self‐care activities mean score (8.62 ± 4.22 versus 9.48 ± 6.60). At follow‐up, significant differences (P < 0.001) were found with regard to number of TRPs (0.62 ± 0.85 versus 2.5 ± 1.50), adherence (0.43 ± 1.13 versus 2.24 ± 2.80) and self‐care activities (13.9 ± 3.90 versus 9.38 ± 6.60). Conclusion Value of the HMMR service has been demonstrated, highlighting the significant role of the community pharmacist in identifying, resolving and preventing TRPs, as well as in improving patients’ health outcomes.

Section: Discussionsupporting

confidence: 56%

“… Paired‐sample t ‐test. Score of adherence (of 4, the lower the score, the better the adherence); score of self‐care activities (score of 42, the higher the score, the better the self‐care activities); score of quality of life (score of 1, the higher the score, the better the quality of life). …”

Section: Resultsmentioning

confidence: 99%

Home medication management review in outpatients with alarming health issues in Jordan: a randomized control trial

J Pharm Health Serv Res

Rizik

Bulatova

2018

Self Cite

“…based on the scale developed previously by Morisky et al . The questionnaire has been applied effectively in previous similar studies . The questionnaire is composed of five items asking patients how often during the last month they forgot to take their medication, skipped their medication, stopped their medication when they felt better, stopped their medication when they felt worse or stopped their medication when they experienced a side effect.…”

Section: Methodsmentioning

confidence: 99%

“…In ambulatory care, the economic burden arising from healthcare resource consumption associated with TRPs has been estimated to be over $177 billion dollars in the US, with potentially preventable hospital admissions due to TRPs costing more than €94 million in the Netherlands . Identifying and preventing TRPs can help patients achieve their therapy goals and reach better possible health outcomes, better quality of life, less hospital admissions and better health economic status …”

Section: Introductionmentioning

confidence: 99%

Revealing treatment-related problems for outpatients with alarming health status in the United Arab Emirates

J Pharm Health Serv Res

Abu‐Gharbieh

2017

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Objectives To explore types and frequencies of treatment‐related problems (TRPs) amongst outpatients with chronic diseases recruited through community pharmacies and clinics in the UAE via conducting the medication management review (MMR) service. Methods This observational study was conducted over three months in 2013 in the UAE. Ethical approval was obtained, and patients were recruited randomly by two pharmacists from different outpatient settings. Patient interview was conducted at the community pharmacy or clinic to collect demographic data, followed by a visit to the patient's home to collect the medical data. TRPs for each patient were identified by the clinical pharmacist. Key findings A total of 125 patients (mean age: 52.40 ± 12.60) completed the study. More than half of the patients (57%) were classified overweight (BMI > 24.90 kg/m2), and many (22%) were smokers. Mean number of medical conditions was 2.77 ± 1.44; mean number of medications taken was 3.12 ± 1.29. Most prevalent diseases included diabetes mellitus (24%), hypertension (21%), coronary artery disease (11%) and asthma (9%). Mean number of identified TRPs was 1.76 ± 1.44 per patient. The most common TRP categories were inappropriate adherence (68.5%), inappropriate dosage regimen (35.4%), untreated conditions (29.2%) and ineffective/incomplete drug therapy (26.2%). Conclusions Prevalence of TRPs among outpatients living in the UAE is a concern that needs addressing. None adherence is a major TRP amongst patients with chronic conditions. The MMR service delivered by pharmacists is needed to identify, prevent and resolve outpatients’ TRPs.

“…Hence, pharmacy practice has grown from the traditional dispensing only duties to now being more patient‐centred based . Pharmacy practice research in the developing countries, such as Jordan, is also paving the way towards patient‐centred care …”

Section: Introductionmentioning

confidence: 99%

Assessing patient satisfaction with the Medication Management Review service delivered in Jordan

Journal of Pharmaceutical Health Services Research

Tadros

Alnajjar³

et al. 2018

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Objective To investigate the effect of the Medication Management Review (MMR) service on the number of treatment‐related problems (TRPs), patient satisfaction and factors affecting patient satisfaction. Methods This prospective, randomized controlled trial was conducted at community pharmacies in Amman, Jordan. Eligible patients were randomized into active and control groups. A validated Pharmaceutical Care Manual was used for data collection and to identify TRPs for both groups. Identified TRPs for patients in the active group were resolved at the pharmacist level or sent to the patients’ physicians for approval and implementation. Patients in both groups were followed up at 3 months to determine the number of TRPs end of the study. Patients in the active group completed a validated, Likert scale MMR‐satisfaction questionnaire. Factors affecting satisfaction were assessed through multiple regression analysis. Key findings Outpatients with chronic conditions (n = 160) were recruited into the study, with mean age 53.01 ± 15.39; mean number of medical conditions of 3.56 ± 1.15 and 4.73 ± 1.79 mean number of medications. A mean number of 5.37 ± 3.01 TRPs per patient was identified, with no significant difference between both groups (active group n = 82, 5.57 ± 2.68; control n = 78, 5.18 ± 3.36, P = 0.412). At follow‐up, significantly lower number of TRPs were identified for patients in the active group compared to patients in the control group (1.06 ± 1.30 versus 4.53 ± 3.43, P < 0.001). Majority of patients were satisfied/very satisfied with the service (n = 77, 94.5%). A lower number of TRPs at follow‐up (B = −0.438; t = −4.477, P < 0.001) and higher number of TRPs agreed upon and implemented (B = 0.553; t = 6.949, P < 0.001) were significantly associated with higher level of patient satisfaction. Conclusion The MMR has proven to be an effective pharmaceutical care service when delivered in a developing country, such as Jordan. It led to high patient satisfaction, which was significantly associated with lower number of TRPs at follow‐up.