The effectiveness of optimised clinical medication reviews for geriatric patients: Opti-Med a cluster randomised controlled trial

Willeboordse, Floor; Schellevis, François G.; Chau, Sek Hung; Hugtenburg, Jacqueline G.; Elders, Petra

doi:10.1093/fampra/cmx007

Cited by 32 publications

(34 citation statements)

References 26 publications

(27 reference statements)

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“…Although previous research in different settings of care assumes a positive effect of an SMR on health outcomes such as QoL and cost-effectiveness, contradictory results are found. Willeboordse et al (2017) found no effect of a medication review concerning QoL in 518 geriatric patients and the chronic use of ≥1 prescribed drug [ 59 ]. One explanation might be the non-complexity of the selected patient group.…”

Section: Discussionmentioning

confidence: 99%

The effect of a structured medication review on quality of life in Parkinson's disease: The study protocol

Oonk

Movig

Münster

et al. 2019

Contemporary Clinical Trials Communications

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BackgroundTreatment of Parkinson's disease (PD) is symptomatic and frequently consists of complicated medication regimes. This negatively influences therapy adherence, resulting in lower benefit of treatment, drug related problems and decreased quality of life (QoL). A potential effective intervention strategy is a structured medication review, executed by community pharmacists. However, little is known about the effects on clinical endpoints like QoL, as well as on feasibility and cost-effectiveness in PD patients.ObjectivesTo assess the effect of a structured medication review on QoL in PD patients. Secondary objectives are measurements of physical disability, activities in daily life, non-motor symptoms, health state, personal carers' QoL and cost-effectiveness. Furthermore, a better insight in the process of performing medication reviews will be obtained from the perspective of community pharmacists.MethodsIn this multicenter randomized controlled trial we aim to enroll 200 PD patients from the outpatient clinic of three Dutch hospitals. Community pharmacists will perform a structured medication review in half of the assigned patients; the other half will receive usual care. Data obtained by use of six validated questionnaires will be collected at baseline and after 3 and 6 months of follow-up. Semi-structured interviews with community pharmacists will be conducted till data saturation has been reached.DiscussionThis trial targets a high-risk patient group for whom optimizing therapy by a structured medication review might be of added value. If effectiveness is proven, this could further promote the implementation of pharmaceutical care in a primary care setting.

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Section: Discussionmentioning

confidence: 99%

The effect of a structured medication review on quality of life in Parkinson's disease: The study protocol

Oonk

Movig

Münster

et al. 2019

Contemporary Clinical Trials Communications

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show abstract

“…Voor een medicatiebeoordeling zijn verschillende werkwijzen beschikbaar (zie o. a. www.medicijngebruik.nl), al of niet in FTO-verband. Er zijn goede ervaringen met de inzet van een expertteam, bestaande uit een (huis)arts en een apotheker voor de farmacotherapeutische analyse en het opstellen van het farmacotherapeutisch behandelplan [12].…”

Section: [Figuur 2] Multidisciplinaire Richtlijn 'Polyfarmacie Bij Ouunclassified

Multimorbiditeit en polyfarmacie

Schellevis

2017

Bijblijven

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“…13 Studies have revealed that the use of STRIP Assistant by general practitioners and pharmacists increases appropriate medication decisions (58-76%), decreases inappropriate decisions (42-24%) and increases the percentage of solved drug-related problems in test cases from general practice. 14,15 As little is known about the effect of STRIP Assistantgenerated prescribing recommendations in a hospital setting, we evaluated whether prescribing recommendations made with the use of the STRIP Assistant improved prescribing in a preoperative geriatric outpatient population. The primary outcome was the number of resident-implemented medication changes made because of PIMs, PPOs, and suboptimal dosages; a secondary outcome was 3-month postoperative mortality.…”

Section: Introductionmentioning

confidence: 99%

The effect of providing prescribing recommendations on appropriate prescribing: A cluster‐randomized controlled trial in older adults in a preoperative setting

Boersma

Huibers

Maanen

et al. 2019

Brit J Clinical Pharma

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Aims The Systematic Tool to Reduce Inappropriate Prescribing is a method to assess patient's medication and has been incorporated into a clinical decision support system: STRIP Assistant. Our aim was to evaluate the effect of recommendations generated using STRIP Assistant on appropriate prescribing and mortality in a preoperative setting. Methods This cluster‐randomized controlled trial was carried out at the preoperative geriatric outpatient clinic. Residents who performed a comprehensive geriatric assessment were randomized to the control group and intervention group in a 1:1 ratio. Visiting patients aged 70 years or older on 5 or more medications were included. Intervention: prescribing recommendations were generated by a physician using STRIP Assistant and given to the resident. Control group residents performed a medication review according to usual care. Primary outcome: number of medication changes made because of potential prescribing omissions (PPOs), potentially inappropriate medications (PIMs), and suboptimal dosages according to the prescribing recommendations. Secondary outcome: 3‐month postoperative mortality. Results 65 intervention and 59 control patients were included, attended by 34 residents. Significantly more medication changes because of PPOs and PIMs were made in the intervention group than in the control group (PPOs 26.2% vs 3.4%, odds ratio 0.04 [95% confidence interval 0.003–0.46] P < .05; PIMS 46.2% vs 15.3% odds ratio 0.14 [95% confidence interval 0.07–0.57] P < .005). There were no differences in dose adjustments or in postoperative mortality. Conclusion Prescribing recommendations generated with the help of STRIP Assistant improved appropriate prescribing in a preoperative geriatric outpatient clinic but did not affect postoperative mortality.

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The effectiveness of optimised clinical medication reviews for geriatric patients: Opti-Med a cluster randomised controlled trial

Abstract: The study intervention did not influence QoL and geriatric problems. The higher percentage of solved DRPs in the intervention group did not result in effects on the patient's health. CMRs on a large scale seem not meaningful and should be reconsidered.

Cited by 32 publications

References 26 publications

The effect of a structured medication review on quality of life in Parkinson's disease: The study protocol

The effect of a structured medication review on quality of life in Parkinson's disease: The study protocol

Multimorbiditeit en polyfarmacie

The effect of providing prescribing recommendations on appropriate prescribing: A cluster‐randomized controlled trial in older adults in a preoperative setting

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