TY - JOUR
T1 - Clinical and humanistic outcomes of community pharmacy‐based healthcare interventions regarding medication use in older adults
T2 - A systematic review and meta‐analysis
AU - Christopher, Christina Malini
AU - Bhuvan, K. C.
AU - Blebil, Ali
AU - Alex, Deepa
AU - Ibrahim, Mohamed Izham Mohamed
AU - Ismail, Norhasimah
AU - Alrasheedy, Alian A.
N1 - Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/11
Y1 - 2021/11
N2 - This review and meta‐analysis aimed to determine the clinical and humanistic outcomes of community pharmacy‐based interventions on medication‐related problems of older adults at the primary care level. We identified randomized controlled trials (RCTs) examining the impact of various community pharmacy‐based interventions from five electronic databases (namely, MEDLINE (Ovid), EMBASE (Ovid), CINAHL, APA PSYInfo, and Scopus) from January 2010 to December 2020. Consequently, we assessed these interventions’ clinical and humanistic outcomes on older adults and compared them with non‐intervention. We included 13 RCTs in the current review and completed a meta‐analysis with six of them. The included studies had a total of 6173 older adults. Quantitative analysis showed that patient education was significantly associated with an increase in the discontinuation of sedative–hypnotics use (risk ratio 1.28; 95% CI (1.20, 1.36) I2 = 0%, p < 0.00001). Moreover, the qualitative analysis showed that medication reviews and education with follow‐ups could improve various clinical outcomes, including reducing adverse drug events, reducing uncontrolled health outcomes, and improving appropriate medication use among the elderly population. However, medication review could not significantly reduce the number of older adults who fall (risk ratio 1.25; 95% CI (0.78, 1.99) I2 = 0%, p = 0.36) and require hospitalization (risk ratio 0.72; 95% CI (0.47, 1.12) I2 = 45%, p = 0.15). This study showed that community pharmacy‐based interventions could help discontinue inappropriate prescription medications among older adults and could improve several clinical and humanistic outcomes. However, more effective community pharmacy‐based interventions should be implemented, and more research is needed to provide further evidence for clinical and humanistic outcomes of such interventions on older adults.
AB - This review and meta‐analysis aimed to determine the clinical and humanistic outcomes of community pharmacy‐based interventions on medication‐related problems of older adults at the primary care level. We identified randomized controlled trials (RCTs) examining the impact of various community pharmacy‐based interventions from five electronic databases (namely, MEDLINE (Ovid), EMBASE (Ovid), CINAHL, APA PSYInfo, and Scopus) from January 2010 to December 2020. Consequently, we assessed these interventions’ clinical and humanistic outcomes on older adults and compared them with non‐intervention. We included 13 RCTs in the current review and completed a meta‐analysis with six of them. The included studies had a total of 6173 older adults. Quantitative analysis showed that patient education was significantly associated with an increase in the discontinuation of sedative–hypnotics use (risk ratio 1.28; 95% CI (1.20, 1.36) I2 = 0%, p < 0.00001). Moreover, the qualitative analysis showed that medication reviews and education with follow‐ups could improve various clinical outcomes, including reducing adverse drug events, reducing uncontrolled health outcomes, and improving appropriate medication use among the elderly population. However, medication review could not significantly reduce the number of older adults who fall (risk ratio 1.25; 95% CI (0.78, 1.99) I2 = 0%, p = 0.36) and require hospitalization (risk ratio 0.72; 95% CI (0.47, 1.12) I2 = 45%, p = 0.15). This study showed that community pharmacy‐based interventions could help discontinue inappropriate prescription medications among older adults and could improve several clinical and humanistic outcomes. However, more effective community pharmacy‐based interventions should be implemented, and more research is needed to provide further evidence for clinical and humanistic outcomes of such interventions on older adults.
KW - Community pharmacy
KW - Intervention
KW - Older adults
KW - Outcomes
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85119851096&partnerID=8YFLogxK
U2 - 10.3390/healthcare9111577
DO - 10.3390/healthcare9111577
M3 - Review Article
C2 - 34828622
AN - SCOPUS:85119851096
SN - 2227-9032
VL - 9
JO - Healthcare
JF - Healthcare
IS - 11
M1 - 1577
ER -
