Outcomes of medication therapy review in a family medicine clinic

Harris, Ila M.; Westberg, Sarah M.; Frakes, Michael J.; Vooren, James S. Van

doi:10.1331/japha.2009.08069

Cited by 14 publications

(13 citation statements)

References 18 publications

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“…Two studies showed small statistically significant increases in medications prescribed in pharmacist interventions, 42,47 (in one of these, medications increased in both intervention and control groups, but to a lesser extent with the intervention 42 ). Four studies showed small statistically significant decreases in medication use with pharmacist intervention, 28,30,44,45 while the remainder showed no statistically significant effect on overall numbers of medications. 22,31,35,36,46 Hospitalisation and ED use Twelve studies assessed the number of hospitalisations or length of stay in hospital, 23,24,29,31,33,[37][38][39][40]42,44,45 and 10 examined ED visits (including urgent care).…”

Section: Medication Usementioning

confidence: 95%

“…These were conducted between 1987 and 2018, and recruited more than 32 000 patients. Fourteen studies were from the US, [21][22][23][24][25][26][27][28][29][30][31][32][33][34] four from Canada, [35][36][37][38] five from the UK, [39][40][41][42][43] one from Sweden, 44 one from Spain, 45 two from Brazil, 46,47 and one from Singapore. 48 Two studies 40,41 were further analyses performed on data from previous studies; the original studies 49,50 had no distinct findings on the relevant outcomes, so only the subsequent analyses were included in the final 28 studies.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Five of the seven observational studies were of fair quality; 24,26,29,30,33 the remaining two were of poor quality; 34,43 none provided sample-size justification or blinded outcome assessors. Experimental studies were all of fair overall quality, but all introduced a high risk of bias in failing to blind participants.…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…Eleven studies assessed the number of medications per patient. 22,28,30,31,35,36,42,[44][45][46][47] Findings were mixed. Two studies showed small statistically significant increases in medications prescribed in pharmacist interventions, 42,47 (in one of these, medications increased in both intervention and control groups, but to a lesser extent with the intervention 42 ).…”

Section: Medication Usementioning

confidence: 99%

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Impact of integrating pharmacists into primary care teams on health systems indicators: a systematic review

Hayhoe¹,

Cespedes

Foley³

et al. 2019

Br J Gen Pract

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BackgroundEvidence suggests that pharmacists integrated into primary care can improve patient outcomes and satisfaction, but their impact on healthcare systems is unclear.AimTo identify the key impacts of pharmacists’ integration into primary care on health system indicators, such as healthcare utilisation and costs.Design and settingA systematic review of literature.MethodEmbase, MEDLINE, Scopus, the Health Management Information Consortium, CINAHL, and the Cochrane Central Register of Controlled Trials databases were examined, along with reference lists of relevant studies. Randomised controlled trials (RCTs) and observational studies published up until June 2018, which considered health system outcomes of the integration of pharmacists into primary care, were included. The Cochrane risk of bias quality assessment tool was used to assess risk of bias for RCTs; the National Institute of Health National Heart, Lung, and Blood Institute quality assessment tool was used for observational studies. Data were extracted from published reports and findings synthesised.ResultsSearches identified 3058 studies, of which 28 met the inclusion criteria. Most included studies were of fair quality. Pharmacists in primary care resulted in reduced use of GP appointments and reduced emergency department (ED) attendance, but increased overall primary care use. There was no impact on hospitalisations, but some evidence of savings in overall health system and medication costs.ConclusionIntegrating pharmacists into primary care may reduce GP workload and ED attendance. However, further higher quality studies are needed, including research to clarify the cost-effectiveness of the intervention and the long-term impact on health system outcomes.

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Section: Medication Usementioning

confidence: 95%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Medication Usementioning

confidence: 99%

See 2 more Smart Citations

Impact of integrating pharmacists into primary care teams on health systems indicators: a systematic review

Hayhoe¹,

Cespedes

Foley³

et al. 2019

Br J Gen Pract

View full text Add to dashboard Cite

show abstract

“…Numerous studies have demonstrated the benefit of pharmacists in a clinic setting. 10–19 Studies have also shown improvements in obtaining standards of care when pharmacists and physicians collaborate. 17,20 Additionally, medication therapy management (MTM) can reduce drug-related adverse events by 50% to 60% and help to avoid $45 billion in direct health care costs.…”

Section: Introductionmentioning

confidence: 99%

Medication Therapy Management in the Primary Care Setting

Koenigsfeld

Horning

Logemann

et al. 2011

Journal of Pharmacy Practice

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A total of 827 patients at 3 clinics were included in the analysis. For diabetes, 77.1% had A1c <8%, 83.2% had LDL <130 mg/dL, and 76.3% had BP <140/80 mm Hg. For hypertension, 86.2% had BP <140/90 mm Hg. For hyperlipidemia, 80.6% had LDL <130 mg/dL. For asthma, 100% were on controller medication. One medication review was completed on 88.8% of patients. Generic prescribing rates ranged from 65.8% to 79.4%. IMPLICATIONS/ADAPTABILITY: A high percentage of patients achieved goal levels at clinics with clinical pharmacist services. A multidisciplinary approach to patient care may improve disease state management and medication cost savings.

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Medication therapy problem documentation and reporting: A review of the literature and recommendations

Armistead

Cruz

Levitt

et al. 2021

J Am Coll Clin Pharm

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Pharmacists are increasingly using medication therapy problem (MTP) metrics to monitor their clinical impact and demonstrate their value to health care organizations and commercial payers. Although the practice of documenting and resolving MTPs is well reported in the literature, there remains great diversity in how MTPs are categorized, documented, and reported. We conducted a review of the literature to gain key insights into the MTP classification systems, methods of MTP documentation, and MTP-related outcomes that are reported in the literature, as well as the elements of MTP documentation that are commonly employed in practice. Ninety-one articles were identified. These insights were used to develop a set of recommendations to help standardize the practice of MTP documentation in the profession. This review highlights the findings from these studies and outlines a set of recommendations for identifying, categorizing, documenting, and monitoring MTPs that can be applied across care settings. The recommendations include clearly defining the purpose for documenting MTPs; using an established, standardized MTP categorization framework and applying that framework consistently in practice; establishing a clear process for identifying and resolving MTPs; systematizing the documentation and reporting process; tracking the resolution of MTPs identified; and monitoring MTP data and assessing impact. MTP identification, documentation, and reporting are an important strategy for capturing, monitoring, and sharing the unique contributions of pharmacists in providing patient care. Although additional research is needed to clearly demonstrate the relationship between MTPs and humanistic, clinical, and economic outcomes, MTP resolution may be a useful process metric to demonstrate the value-added role of the pharmacist in the delivery of team-based, patient-centered care.clinical pharmacy services, drug, health care, medication therapy management, outcome and process assessment | INTRODUCTIONThe primary goal of health care is to improve the health and wellbeing of patients. Medications play a significant role in the prevention and treatment of short-term and long-term therapy disease, and pharmacists are uniquely poised as highly educated and trained medication specialists to optimize medication use and improve the health of patients. 1 Through the provision of comprehensive medication management (CMM), pharmacists helps ensure patients' medications are appropriate, effective, and safe, and that patients are adhering to

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Outcomes of medication therapy review in a family medicine clinic

Cited by 14 publications

References 18 publications

Impact of integrating pharmacists into primary care teams on health systems indicators: a systematic review

Impact of integrating pharmacists into primary care teams on health systems indicators: a systematic review

Medication Therapy Management in the Primary Care Setting

Medication therapy problem documentation and reporting: A review of the literature and recommendations

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