Decision support software-guided medication reviews in elderly patients with polypharmacy: a prospective analysis of routine data from community pharmacies (OPtiMed study protocol)

Journal of Pharmaceutical Policy and Practice

Study Protocol

Susanne Koling¹  Gudrun Würthwein²  Isabell Waltering²  Stefan Maierhöfer²  Georg Hempel²  Mareike Jacobs³  Meike Appelrath³ 

[1] Clinic for Pediatrics and Adolescent Medicine — Evangelical Hospital Hamm, Hamm, Germany;Department of Pharmaceutical and Medicinal Chemistry — Clinical Pharmacy, Westfaelische Wilhelms-University, Muenster, Germany;Viandar GmbH, Lengerich, Germany;

关键词: Polypharmacy;    Pharmaceutical care;    Medication safety;    Medication review;    Clinical decision support system;    Health information technology;   

DOI  :  10.1186/s40545-022-00495-z

 received in 2022-08-16, accepted in 2022-11-17,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundPharmacist-led medication reviews are considered a valuable measure to address risks of polypharmacy. The software Medinspector® is used in community pharmacies to assist the performance of this complex service by structuring the medication review process and supporting pharmacists in their decision-making with targeted clinical knowledge. Key feature is a computerized risk assessment of both the initial and adjusted medication regimen of a patient in multiple domains, thus aiming to support the identification and solving of drug-related problems. This study will examine the effects of medication reviews performed with the clinical decision support system in daily routine practice on medication-related and patient-reported outcomes in elderly patients with polypharmacy.MethodsA prospective, before–after observational study is conducted in German community pharmacies aiming to include 148 patients aged 65 or older, who chronically use five or more active pharmaceutical substances with systemic effects and utilize the software-supported medication review service. The study is based on routine documentation within the software over the course of the medication review, including a patient’s baseline medication, the medication proposed by pharmacists, and the final medication regimen. A software-implemented questionnaire comprising self-developed and literature-derived instruments is used to collect patient-reported outcome data at baseline and follow-up. Primary outcome is the appropriateness of medication measured with an adapted version of the Medication Appropriateness Index (MAI). Secondary medication-related outcomes are medication underuse, exposition towards anticholinergic/sedative drugs, number of drugs in long-term use and the implementation of pharmacist-proposed medication adjustments by the physicians. Secondary patient-reported outcomes are symptom burden, medication-related quality of life, adherence, fulfillment of medication review-related goals, and perception of the service.DiscussionWith the recently introduced remuneration of community pharmacist-led MR in Germany, the demand for digital tools supporting the MR process is assumed to rise. The OPtiMed-study is expected to create evidence on the effects of a novel tool on patient care in a vulnerable patient population.Trial registration German Clinical Trials Register, DRKS00027410. Registered 22 December 2021, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00027410. Also available on the WHO meta-registry: https://trialsearch.who.int/?TrialID=DRKS00027410

【 授权许可】

CC BY   
© The Author(s) 2022

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