The effect of home medication review in community-dwelling older adults: a systematic review

Fadaleh, Sarah M. Abu; Charrois, Theresa L.; Makhinova, Tatiana; Eurich, Dean T.; Rahman, Sholeh; Sadowski, Cheryl A.

doi:10.1007/s10389-020-01447-0

Cited by 6 publications

(24 citation statements)

References 37 publications

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“…Twelve systematic reviews included only randomised controlled trials (RCTs) [8][9][10][11][12][13][14][15][16][17][18][19], one included only non-randomised studies [20] and all other reviews included both randomised and non-randomised trials [21][22][23][24][25][26][27][28][29][30][31].…”

Section: Description Of Extent and Range Of Pharmacist-led Medication...mentioning

confidence: 99%

“…The original studies in the included 24 systematic reviews were conducted in a wide range of countries across ve continents (Supplementary le 2 Table 1). Eight reviews included populations restricted by age: seven included studies with older adults [8, 9,11,13,19,21,24] and one children and adolescents [22]. Two reviews included patient populations with cardiovascular disease and/ or other chronic conditions [15,16].…”

Section: Description Of Extent and Range Of Pharmacist-led Medication...mentioning

confidence: 99%

“…The most frequently reported outcome was effects of medication reviews on healthcare utilisation, which includes hospital admissions, re-admissions, and access to primary care physicians. Eight of the seventeen reviews [8,11,12,19,20,26,27,31] reported that MRs no evidence of a positive effect on healthcare utilisation. Seven reviews [9,13,17,22,[28][29][30] reported mixed evidence of a positive effect on healthcare utilisation and that the effect of MRs was uncertain, whilst one high quality and one critically low review [18,23] reported a reduction in hospital (re)admissions.…”

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

confidence: 99%

“…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%

“…Three reviews [10,11,28] reported that the MR did not improve quality of life, but the remaining nine reviews showed mixed results. Eight reviews reported mixed outcomes for patient satisfaction following MRs [8, 10,12,19,20,22,28,30]. Evidence for MRs having a positive effect on medication-related problems is inconclusive due to mixed results.…”

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

confidence: 99%

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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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Section: Description Of Extent and Range Of Pharmacist-led Medication...mentioning

confidence: 99%

Section: Description Of Extent and Range Of Pharmacist-led Medication...mentioning

confidence: 99%

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

confidence: 99%

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

confidence: 99%

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

confidence: 99%

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

Craske

Hardeman

Steel

et al. 2023

Preprint

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Health Outcomes Following Provision of Home Medicines Reviews for Older Persons Receiving Aged Care Services at Home

Sluggett,

Caughey,

Air

et al. 2024

Research in Social and Administrative Pharmacy

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Deprescribing interventions in older adults: An overview of systematic reviews

Chua,

Todd,

Reeve

et al. 2024

PLoS ONE

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Objective The growing deprescribing field is challenged by a lack of consensus around evidence and knowledge gaps. The objective of this overview of systematic reviews was to summarize the review evidence for deprescribing interventions in older adults. Methods 11 databases were searched from 1st January 2005 to 16th March 2023 to identify systematic reviews. We summarized and synthesized the results in two steps. Step 1 summarized results reported by the included reviews (including meta-analyses). Step 2 involved a narrative synthesis of review results by outcome. Outcomes included medication-related outcomes (e.g., medication reduction, medication appropriateness) or twelve other outcomes (e.g., mortality, adverse events). We summarized outcomes according to subgroups (patient characteristics, intervention type and setting) when direct comparisons were available within the reviews. The quality of included reviews was assessed using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2). Results We retrieved 3,228 unique citations and assessed 135 full-text articles for eligibility. Forty-eight reviews (encompassing 17 meta-analyses) were included. Thirty-one of the 48 reviews had a general deprescribing focus, 16 focused on specific medication classes or therapeutic categories and one included both. Twelve of 17 reviews meta-analyzed medication-related outcomes (33 outcomes: 25 favored the intervention, 7 found no difference, 1 favored the comparison). The narrative synthesis indicated that most interventions resulted in some evidence of medication reduction while for other outcomes we found primarily no evidence of an effect. Results were mixed for adverse events and few reviews reported adverse drug withdrawal events. Limited information was available for people with dementia, frailty and multimorbidity. All but one review scored low or critically low on quality assessment. Conclusion Deprescribing interventions likely resulted in medication reduction but evidence on other outcomes, in particular relating to adverse events, or in vulnerable subgroups or settings was limited. Future research should focus on designing studies powered to examine harms, patient-reported outcomes, and effects on vulnerable subgroups. Systematic Review Registration PROSPERO CRD42020178860.

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The effect of home medication review in community-dwelling older adults: a systematic review

Cited by 6 publications

References 37 publications

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

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

Health Outcomes Following Provision of Home Medicines Reviews for Older Persons Receiving Aged Care Services at Home

Deprescribing interventions in older adults: An overview of systematic reviews

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