Studying the impact of a medication use evaluation by the community pharmacist (Simenon): Drug-related problems and associated variables

Wuyts, Joke; Maesschalck, Joris; Wulf, Isabelle De; Lelubre, Mélanie; Foubert, Katrien; Vriese, Carine De; Boussery, Koen; Goderis, Geert; Lepeleire, Jan De; Foulon, Veerle

doi:10.1016/j.sapharm.2019.11.008

Cited by 9 publications

(9 citation statements)

References 31 publications

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“…In the SIMENON study, 1.196 drug‐related problems were reported by pharmacists in 88.3% of patients but only 42 DRPs (3.5%) were classified as non‐adherence issues 21 . This strongly contrasts with the results of this independent analysis identifying non‐adherence in 316 medications across 195 patients.…”

Section: Discussionmentioning

confidence: 77%

“…Medication refill data were collected from 40 pharmacies for a total of 316 patients, representing 70% (316/453) of participants in the SIMENON study 21 . The descriptive characteristics of the adherence sample are shown in Table 3, as well as the characteristics of all SIMENON study participants.…”

Section: Resultsmentioning

confidence: 99%

“…In all likelihood, the MUR indirectly improved adherence implementation rates by resolving DRPs related to medication use (306/1196 DRPs; 25.6% related to inappropriate timing or frequency of administration, inappropriate application or inappropriate therapy duration) and patient‐related DRPs (128/1196; 10.7% related to treatment concerns and knowledge) 21 . Furthermore, how patients use their medication, including the time of intake, relation to food or posology, are relevant components of adherence that can be improved during a MUR but cannot be measured with refill data.…”

Section: Discussionmentioning

confidence: 99%

“…The impact of the SIMENON study on DRPs has already been published 21 . The secondary outcome of the study, described in this paper, was the adherence rate for each chronic therapy used by the patient.…”

Section: Methodsmentioning

confidence: 99%

“…The SIMENON study was set up to Study the Impact of a Medication use EvaluatioN by the cOmmuNity pharmacist 20 . The study already demonstrated that Belgian community pharmacists detect DRPs in the vast majority of older patients with polypharmacy (88.3%) during a medication use review (MUR), a type of medication review 21 . Patient‐reported experiences were positive and patient‐reported outcome measures suggested reduced medication burden 22 .…”

Section: Introductionmentioning

confidence: 99%

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Does a pharmacist‐led medication use review improve medication adherence in polymedicated aged patients? Methodological choices matter!

Wuyts

Maesschalck

Hamelinck

et al. 2021

Evaluation Clinical Practice

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Rationale, aims and objectives The rise in chronic diseases urges for an identification of interventions that improve adherence. However, no golden standard exists for evaluating adherence in polymedicated patients. The objectives were to investigate the impact of a pharmacist‐led medication use review (MUR) service on adherence implementation rates for chronic medication, and to evaluate the appropriateness of two adherence calculation approaches in this regard. Method Before‐after study (SIMENON study) including ambulatory, aged, polymedicated patients. Refill data were used to calculate the proportion of days covered (PDC) per medication before and after the MUR. Adherence was assessed for chronic, solid, oral medication using a prescription‐based and interval‐based approach, and the performance of both approaches was compared. Results Adherence was evaluated for 1483 medications from 316 patients. The median baseline PDC per medication was 0.95 (prescription‐based method) and 0.91 (interval‐based approach). Pearson correlation between both approaches was 0.616 (P < .0001). The prescription‐based approach found less medication below the adherence threshold of 0.80 (319 medications; 21.5% vs 481 medications; 32.4%). Using the prescription‐based approach, the proportion of non‐adherent patients at baseline was 61.7% (195/316 patients), of which 54.9% (107/195 patients) was only non‐adherent for one medication. Median PDC scores increased significantly from 0.95 to 0.99 and 0.91 to 0.99 with the prescription‐based and interval‐based approach respectively (both P < .0001). Only considering the 319 medications with baseline PDC scores <0.8 using the prescription‐based approach, the median PDC scores significantly increased from 0.67 to 0.84 (P < .0001), with a median score improvement of 18.3%. Conclusions Although baseline adherence was high in this population of polymedicated aged patients, both calculation methods showed the MUR significantly improved adherence. The prescription‐based approach was considered the most appropriate method. Based on these findings and literature evidence, it is recommended to implement the MUR service in Belgium and target non‐adherent patients for maximal effect.

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Section: Discussionmentioning

confidence: 77%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Does a pharmacist‐led medication use review improve medication adherence in polymedicated aged patients? Methodological choices matter!

Wuyts

Maesschalck

Hamelinck

et al. 2021

Evaluation Clinical Practice

Self Cite

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Pharmaceutical Interventions on Hospital Discharge Prescriptions: Prospective Observational Study Highlighting Challenges for Community Pharmacists

Grandchamp

Blanc

Roussel

et al. 2021

Drugs - Real World Outcomes

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Background Transition between hospital and ambulatory care is a delicate step involving several healthcare professionals and presenting a considerable risk of drug-related problems. Objective To investigate pharmaceutical interventions made on hospital discharge prescriptions by community pharmacists. Method This observational, prospective study took place in 14 community pharmacies around a Swiss acute care hospital. We recruited patients with discharge prescriptions (minimum three drugs) from the internal medicine ward of the hospital. The main outcome measures were: number and type of pharmaceutical interventions made by community pharmacists, time spent on discharge prescriptions, number of medication changes during the transition of care. ResultsThe study included 64 patients discharged from the hospital. Community pharmacists made a total of 439 interventions; a mean of 6.9 ± 3.5 (range 1-16) interventions per patient. All of the discharge prescriptions required pharmaceutical intervention, and 61 (95%) necessitated a telephone call to the patients' hospital physician for clarifications. The most frequent interventions were: confirming voluntary omission of a drug (31.7%), treatment substitution (20.5%), dose adjustment (16.9%), and substitution for reimbursement issues (8.8%). Roughly half (52%) of all discharge prescriptions required 10-20 min for pharmaceutical validation. The mean number of medication changes per patient was 16.4: 9.6 changes between hospital admission and discharge, 2.6 between hospital discharge and community pharmacy, and 4.2 between community pharmacy and a general practitioner's appointment. Conclusion Hospital discharge prescriptions are complex and present a significant risk of medication errors. Community pharmacists play a key role in preventing and identifying drug-related problems.

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The impact of community pharmacists on older adults in Turkey

Okuyan¹,

Ozcan²,

Balta³

et al. 2021

Journal of the American Pharmacists Association

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Studying the impact of a medication use evaluation by the community pharmacist (Simenon): Drug-related problems and associated variables

Cited by 9 publications

References 31 publications

Does a pharmacist‐led medication use review improve medication adherence in polymedicated aged patients? Methodological choices matter!

Does a pharmacist‐led medication use review improve medication adherence in polymedicated aged patients? Methodological choices matter!

Pharmaceutical Interventions on Hospital Discharge Prescriptions: Prospective Observational Study Highlighting Challenges for Community Pharmacists

The impact of community pharmacists on older adults in Turkey

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