Evaluating the impact of general practice pharmacist-led person-centred medicines reviews on medicines appropriateness and patient-reported outcome measures

IF 3 3区医学 Q2 PHARMACOLOGY & PHARMACY British journal of clinical pharmacology Pub Date : 2025-02-10 DOI:10.1111/bcp.16372

Clare Kinahan, Ciara Kirke, Leon O'Hagan, Frank Moriarty, Kevin D. Murphy, Laura J. Sahm, Cian O'Mahony, Emma J. Coyle, Stephen Byrne, Kieran Dalton

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Abstract

Aim

The aim of this study was to investigate the impact of pharmacist-led person-centred medicines reviews in general practices on medicines appropriateness, polypharmacy indicators (high-risk prescribing markers), and patient-reported outcome measures (PROMs).

Methods

Four pharmacists conducted person-centred medicines reviews in ten general practices between January 2021 and December 2022 for patients with hyperpolypharmacy (prescribed ≥10 regular medicines) and/or at high risk of medicines-related harm. Prescribing recommendations were provided to the general practitioner and followed up with patients and/or healthcare professionals. In this single arm study, pre and post intervention: (1) polypharmacy indicators were documented, and for a sample of patients, the (2) Person-Centred Medication Appropriateness Index (PC-MAI) scores and (3) PROMs were gathered.

Results

Of the 1471 included patients, the mean age was 76 years, 88.4% had hyperpolypharmacy, whilst the mean number of medicines was 13.8 pre and 12.3 post review. Of the 1056 polypharmacy indicator occurrences identified, 70.7% were resolved post review. Of the 194 patients with pre-review and post-review PC-MAI scores, 99% had a reduction; the mean reduction was 17.3 (95% confidence interval [CI] 15.8–18.8, P < .0001) per patient and 1.2 (95% CI 1.0–1.3, P < .0001) per medicine. PROMs were collected for 179 patients; 87.7% reported the review helped their medicines understanding, 63.1% their experience of side effects, 36.9% their ability to take medicines correctly, and 30.5% the impact of medicines on their daily activities.

Conclusions

General practice pharmacist-led person-centred medicines reviews for patients with hyperpolypharmacy and/or at high risk of medicines-related harm delivered substantial improvements in medicines appropriateness and patient-reported outcomes, thus providing evidence to support their wider implementation.

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评估全科药剂师主导的以人为本的药物审查对药物适宜性和患者报告结果指标的影响。

目的：本研究的目的是调查药剂师主导的以人为中心的全科医学评价对药物适宜性、多药指标（高风险处方标记）和患者报告的结果测量（PROMs）的影响。方法：在2021年1月至2022年12月期间，4名药剂师在10家全科医院对多药（处方≥10种常规药物）和/或药物相关危害高风险患者进行了以人为中心的药物综述。向全科医生提供处方建议，并与患者和/或医疗保健专业人员进行随访。在这项单臂研究中，干预前和干预后：(1)记录了多种药物指标，并收集了患者样本(2)以人为中心的药物适当性指数（PC-MAI）评分和(3)PROMs。结果：1471例患者中，平均年龄76岁，88.4%患者为多药，复查前平均用药次数13.8次，复查后平均用药次数12.3次。在确定的1056个多药指标中，70.7%在评审后得到解决。在评价前和评价后PC-MAI评分的194例患者中，99%的患者得分降低；平均降幅为17.3（95%可信区间[CI] 15.8-18.8）。结论：全科医生主导的针对多药和/或药物相关危害高风险患者的以人为本的药物评价在药物适宜性和患者报告的结果方面取得了实质性改善，从而为支持其更广泛的实施提供了证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British journal of clinical pharmacology 医学-药学

CiteScore

6.30

自引率

8.80%

发文量

419

审稿时长

1 months

期刊介绍： Published on behalf of the British Pharmacological Society, the British Journal of Clinical Pharmacology features papers and reports on all aspects of drug action in humans: review articles, mini review articles, original papers, commentaries, editorials and letters. The Journal enjoys a wide readership, bridging the gap between the medical profession, clinical research and the pharmaceutical industry. It also publishes research on new methods, new drugs and new approaches to treatment. The Journal is recognised as one of the leading publications in its field. It is online only, publishes open access research through its OnlineOpen programme and is published monthly.