Optimising Pharmacist-led Medication Reviews in Primary Care (OPen): a Qualitative Study to Co-design and Test an Optimised Medication Review for Patients With Long-term Conditions.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 15
- 试验地点
- 3
- 主要终点
- Patient feasibility and acceptability
研究概览
简要总结
An increasing number of people are diagnosed with long-term conditions and are prescribed medicines to manage these conditions. Medication reviews (MRs) are used to optimise medicines, improve health outcomes, and decrease medicines related problems.
Although medication reviews are widely used in health care settings, there has not been a dramatic change in the the rate at which patients experience poor medicines outcomes such as adverse drug reactions and hospitalisations.
This research wants to understand how medication reviews by pharmacists are delivered in GP surgeries and community pharmacies. The research team plans to test a co-designed document, which outlines what pharmacists should do in a MR, in a small number of GP surgeries, on a limited number of patients.
Pharmacists and patients who have used this document will be interviewed to understand their thoughts and feelings about the process.
详细描述
Approximately 15 million people in England have a long-term condition (LTC) or chronic disease, such as heart disease, asthma, diabetes, for which there is currently no cure. Long-term conditions are mostly managed by medicines with 1.12 billion prescription items dispensed in England in 2019 at a total cost of £9.08 billion. Recent government reports have identified that prescribing too many or inappropriate medicines can lead to more medicines related problems and poor patient outcomes, such as drug interactions, adverse drug reactions, reduced quality of life, and hospitalisations.
Medication reviews are used to support patients with their medicines and to reduce the risk of over and inappropriate prescribing. Desired outcomes for medication reviews include optimising medicines, improving health outcomes, and decreasing medicines related problems. It has become more common for medication reviews to be used by doctors, nurses, and pharmacists in the last ten years, but the rate at which patients experience poor medicines outcomes such as adverse drug reactions and hospitalisations because of medicines use has not changed much in this time.
Pharmacists are considered to be medicines experts, so many organisations are encouraging them to be involved with the delivery of medication reviews. Pharmacists currently undertake various types of medication reviews in general practitioner (GP) surgeries, Primary Care Networks (PCN), and community pharmacies.
When interventions are introduced to address problems such as overprescribing, it is important to better understand how they have been designed and delivered. The Medical Research Council (MRC) has provided guidance on the process evaluation of complex interventions (of which medication reviews are an example).
This states that the key steps in evaluating complex interventions are:
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Aged ≥ 18 years
- •Due for a medication review by the practice pharmacist
- •Effectively communicate in English
- •Provide informed consent
排除标准
- •Have no access to telephone/ internet
- •Recently received a medication review
结局指标
主要结局
Patient feasibility and acceptability
时间窗: 3 months
Patients will be interviewed to assess their thoughts and feelings after receiving the medication review
Pharmacist feasibility and acceptability
时间窗: 3 months
Pharmacists will be interviewed to assess their thoughts and feelings after delivering medication reviews using the service specification
次要结局
未报告次要终点