Impact of pharmacist‐led interventions on patient care in ambulatory care settings: A systematic review

Malham, Carmela Bou; Khatib, Sarah El; Cestac, Philippe; Andrieu, Sandrine; Rouch, Laure; Salameh, Pascale

doi:10.1111/ijcp.14864

Cited by 18 publications

(19 citation statements)

References 63 publications

(383 reference statements)

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“…Assessing patient satisfaction with pharmacist-led services including medication reviews and medication optimization is increasingly investigated in research ( Moczygemba et al, 2010 ; Kim et al, 2016 ; Cardosi et al, 2018 ; Nigussie and Edessa, 2018 ; Basheti et al, 2019 ; Jordan et al, 2021 ; Kabba et al, 2021 ; Kebede et al, 2021 ). A recent systematic review showed high patient satisfaction toward pharmacist-led medication review interventions ( Bou Malham et al, 2021 ). In addition, patients showed a positive attitude toward pharmacists’ competencies and involvement in deprescribing, especially the elderly ( Bužančić et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

A pharmacist-led medication review service with a deprescribing focus guided by implementation science

et al. 2023

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Background: Little research addressed deprescribing-focused medication optimization interventions while utilizing implementation science. This study aimed to develop a pharmacist-led medication review service with a deprescribing focus in a care facility serving patients of low income receiving medications for free in Lebanon followed by an assessment of the recommendations’ acceptance by prescribing physicians. As a secondary aim, the study evaluates the impact of this intervention on satisfaction compared to satisfaction associated with receiving routine care.Methods: The Consolidated Framework for Implementation Research (CFIR) was used to address implementation barriers and facilitators by mapping its constructs to the intervention implementation determinants at the study site. After filling medications and receiving routine pharmacy service at the facility, patients 65 years or older and taking 5 or more medications, were assigned into two groups. Both groups of patients received the intervention. Patient satisfaction was assessed right after receiving the intervention (intervention group) or just before the intervention (control group). The intervention consisted of an assessment of patient medication profiles before addressing recommendations with attending physicians at the facility. Patient satisfaction with the service was assessed using a validated translated version of the Medication Management Patient Satisfaction Survey (MMPSS). Descriptive statistics provided data on drug-related problems, the nature and the number of recommendations as well as physicians’ responses to recommendations. Independent sample t-tests were used to assess the intervention’s impact on patient satisfaction.Results: Of 157 patients meeting the inclusion criteria, 143 patients were enrolled: 72 in the control group and 71 in the experimental group. Of 143 patients, 83% presented drug-related problems (DRPs). Further, 66% of the screened DRPs met the STOPP/START criteria (77%, and 23% respectively). The intervention pharmacist provided 221 recommendations to physicians, of which 52% were to discontinue one or more medications. Patients in the intervention group showed significantly higher satisfaction compared to the ones in the control group (p < 0.001, effect size = 1.75). Of those recommendations, 30% were accepted by the physicians.Conclusion: Patients showed significantly higher satisfaction with the intervention they received compared to routine care. Future work should assess how specific CFIR constructs contribute to the outcomes of deprescribing-focused interventions.

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Section: Introductionmentioning

confidence: 99%

A pharmacist-led medication review service with a deprescribing focus guided by implementation science

et al. 2023

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“…Effects of MRs on medication adherence was the second most reported outcome. Two critically low reviews reported that MRs improved adherence [20,24], another stated that there was no evidence of a positive effect [11], whilst the remaining reviews were uncertain of the impact due to mixed results in primary studies [8, 14,17,19,22,27,29,30].…”

Section: Reported Outcomes and Evidence For Effectiveness Of Medicati...mentioning

confidence: 99%

Pharmacist-led medication reviews: A scoping review of systematic reviews

Craske

Hardeman

Steel

et al. 2023

Preprint

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Background Medication reviews aim to support patients who take medicines, and they are often led by pharmacists. Previous research undertaken in 2015 found mixed evidence that medication reviews in community settings improve clinical outcomes, but further work needs to be undertaken to establish their impact on patient-orientated and economic outcomes. Aim To explore the extent and range of systematic reviews of medication reviews conducted by pharmacists, the nature of the intervention, the evidence for effectiveness, and reported research gaps. Method Data extracted included the design of included studies, population, setting, main results, description of interventions, and future research recommendations. Results We identified twenty-four systematic reviews which reported that medication review interventions were diverse, and their nature was often poorly described. Two high quality reviews reported that there was evidence of no effect on mortality; of these one reported an improvement in medicines-related problems (all studies reported an increase of identified problems), and another a reduction in hospital readmissions (Risk ratio 0.93). Other lower quality reviews reported evidence supporting intervention effectiveness for some clinical outcomes (odds ratio: achieving diabetes control = 3.11, achieving blood pressure target = 2.73, 3.50). Conclusion There is mixed evidence of effectiveness for medication reviews across settings and patient populations. The nature of the intervention is poorly reported therefore it is difficult to determine the components medication review. As medication reviews are widely implemented in practice, further research should explore the nature of the interventions and linking the components of these to outcomes.

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“…Their intervention can help to improve medication adherence and prevent drug interactions and adverse events, contributing to the rational use of medicines [ 38 ]. Pharmacists can have a particular role in helping manage forgetfulness, difficulties in managing medication, and concerns with side effects, since these are the most frequent medication-nonadherence-related factors pointed out by older adults [ 39 ] Malham et al [ 40 ] showed that pharmacist-led interventions could play a major role in the management of medicine-related-problems and economic issues in ambulatory care. These studies carry important information to discuss the role of the pharmacist in the healthcare system.…”

Section: Ageing and The Elderlymentioning

confidence: 99%

Pharmacist Intervention in Portuguese Older Adult Care

et al. 2022

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Healthy ageing has become one of the most significant challenges in a society with an increasing life expectancy. Older adults have a greater prevalence of chronic disease, with the need for multiple medications to appropriately control these issues. In addition to their health concerns, ageing individuals are prone to loneliness, dependence, and economic issues, which may affect their quality of life. Governments and health professionals worldwide have developed various strategies to promote active and healthy ageing to improve the quality of life of older adults. Pharmacists are highly qualified health professionals, easily accessible to the population, thus playing a pivotal role in medication management. Their proximity to the patient puts them in a unique position to provide education and training to improve therapeutic adherence and identify medication-related problems. This paper aims to address the importance of Portuguese community pharmacists in the medication management of older adults, emphasising their intervention in health promotion, patient education, medication-related problems, deprescription, dose administration aids, and medication review and reconciliation. We also discuss home delivery services and medication management in long-term care facilities.

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Impact of pharmacist‐led interventions on patient care in ambulatory care settings: A systematic review

Cited by 18 publications

References 63 publications

A pharmacist-led medication review service with a deprescribing focus guided by implementation science

A pharmacist-led medication review service with a deprescribing focus guided by implementation science

Pharmacist-led medication reviews: A scoping review of systematic reviews

Pharmacist Intervention in Portuguese Older Adult Care

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