School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, Subang Jaya, Selangor, Malaysia.
School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia.
Int J Clin Pharm. 2024 Aug;46(4):843-853. doi: 10.1007/s11096-024-01711-3. Epub 2024 Apr 18.
Medication review with follow-up is essential for optimising medication utilisation among the older adult population in primary healthcare.
This study aimed to evaluate the feasibility of implementing medication reviews with follow-up for older adults in community pharmacies and examined potential outcomes on medication use.
A pilot randomised controlled trial was conducted with 4 cluster-randomised community pharmacies to assess the feasibility of the intervention. Two community pharmacies served as intervention and control groups. Both groups recruited older adults over 60 who were followed over 6 months. The translated Medication use Questionnaire (MedUseQ) was administered at baseline and 6 months for both groups. The outcomes were to assess the feasibility of conducting medication review with follow-up and the probable medication use outcomes from the intervention.
The intervention and control groups comprised 14 and 13 older adults. A total of 35 recommendations were made by pharmacists in the intervention group and 8 in the control group. MedUseQ was easily administered, providing some evidence the feasibility of the intervention. However, there were feasibility challenges such as a lack of pharmacists, collaborative practice, difficulties with the tool language, time constraints, and limited funds. Questionnaire results provided a signal of improvement in medication administration, adherence, and polypharmacy among intervention participants. The incidence of drug related problems was significantly higher in the control group (median = 1) after 6 months, U = 15, z = - 2.98, p = 0.01.
Medication review with follow-up is potentialy practical in community pharmacies, but there are feasibility issues. While these challenges can be addressed, it is essential to study larger sample sizes to establish more robust evidence regarding outcomes.
ClinicalTrials.Gov NCT05297461.
在初级医疗保健中，对老年人进行药物审查和随访对于优化药物利用至关重要。
本研究旨在评估在社区药房实施老年人药物审查和随访的可行性，并研究药物使用的潜在结果。
采用 4 个社区药房的试点随机对照试验评估干预措施的可行性。两个社区药房作为干预组和对照组。两组均招募 60 岁以上的老年人，并随访 6 个月。在基线和 6 个月时，两组均使用翻译后的《药物使用问卷》（MedUseQ）进行评估。结果是评估进行药物审查和随访的可行性以及干预措施可能产生的药物使用结果。
干预组和对照组各有 14 名和 13 名老年人。干预组的药剂师共提出 35 条建议，对照组提出 8 条。MedUseQ 易于管理，为干预的可行性提供了一些证据。然而，也存在一些可行性挑战，如药剂师缺乏、合作实践、工具语言困难、时间限制和资金有限。问卷结果提供了一个信号，表明干预组的药物管理、依从性和多药治疗有改善。6 个月后，对照组的药物相关问题发生率明显更高（中位数=1），U=15，z=-2.98，p=0.01。
在社区药房中，药物审查和随访具有潜在的实用性，但存在可行性问题。虽然这些挑战可以得到解决，但研究更大的样本量对于建立更可靠的结果证据至关重要。
ClinicalTrials.Gov NCT05297461。
