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The aging population size has been enlarging globally. A higher number of older adults means a higher number of medication use. It is estimated that older adults are the largest medication consumers.That would result in various medication use problems which provide a link between polypharmacy, inappropriate medication, and deprescribing.[2] Primary health care providers especially community pharmacists are often the first point of healthcare towards older adults.[3] Various interventions are being carried out by community pharmacies to determine an optimal outcome on medication usage.
Medication review intervention is a clinical process where a pharmacist reviews a patient's medication, identifies any drug-related problems and suggests strategies to reduce the medication use problems. Medication review is being utilized in various countries especially in Organisation for Economic Co-operation and Development (OECD )regions ie Australia, New Zealand, the United Kingdom, and the United States of America, and the pharmacist were remunerated for the service. Although medication review is widely searched intervention globally, the scope for intervention is lacking in low and middle-income countries.
Community pharmacy is regarded as the first point of care of primary health care in a community for older adults. A systemic review search on community pharmacist-led intervention among the aging population has demonstrated medication adherence improvement outcomes. Consequently, community pharmacists can reduce medication use problems in different settings in the community in various ways and contribute to the patients' overall well-being and health-related quality of life.
There is a lack of information in Malaysia due to the fragmented health care system where there is no continuity of care between the public and private sectors. During this pandemic outbreak, when most countries suffer critical health care points, much effort and pharmaceutical care should be delivered towards older adults to reduce the current burden. This study assesses the feasibility of medication review for older adults at the community pharmacy level and identifies any medication-related problems in Penang state. The significance of this study is improving medication use among older adults at a primary care level and will probably upgrade the quality of the Malaysian health care system by providing some program and policy level solutions towards the problems.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Medication Review | Experimental | The intervention group will receive medication review intervention which includes reviewing older adults' medications and identifying any drug-related problems. |
|
| Standard Care | No Intervention | The standard care includes the current existing care provided to patients in the community pharmacy. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Medication review | Other | Community pharmacy benchmarking guideline Pharmaceutical Services Division provides guidelines for medication review in community pharmacy settings in Malaysia |
| Measure | Description | Time Frame |
|---|---|---|
| Assessing feasibility: intervention time | Length of intervention (minutes) | 6 months |
| Assessing feasibility: Number of staffs | Number of staffs | 6 months |
| Assessing feasibility: Access to prescribers | Number of prescribers contacted | 6 months |
| Type and number medication-related problem |
| 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Northern MCPG | George Town | Pulau Pinang | Malaysia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21328769 | Background | Marek KD, Antle L. Medication Management of the Community-Dwelling Older Adult. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 18. Available from http://www.ncbi.nlm.nih.gov/books/NBK2670/ | |
| 31673327 | Background |
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| ID | Term |
|---|---|
| D000090143 | Medication Review |
| ID | Term |
|---|---|
| D008509 | Medication Systems |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
| D010346 | Patient Care Management |
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| Mangin D, Garfinkel D. Foreword to the first special collection: Addressing the invisible iatrogenic epidemic: the role of deprescribing in polypharmacy and inappropriate medication use. Ther Adv Drug Saf. 2019 Oct 21;10:2042098619883156. doi: 10.1177/2042098619883156. eCollection 2019. No abstract available. |
| 25606105 | Background | Ramli A, Taher S. Managing chronic diseases in the malaysian primary health care - a need for change. Malays Fam Physician. 2008 Apr 30;3(1):7-13. eCollection 2008. |
| 22607195 | Background | Blenkinsopp A, Bond C, Raynor DK. Medication reviews. Br J Clin Pharmacol. 2012 Oct;74(4):573-80. doi: 10.1111/j.1365-2125.2012.04331.x. |
| 19448788 | Background | Lee E, Braund R, Tordoff J. Examining the first year of Medicines Use Review services provided by pharmacists in New Zealand: 2008. N Z Med J. 2009 Apr 24;122(1293):3566. |
| 20331323 | Background | Ramalho de Oliveira D, Brummel AR, Miller DB. Medication therapy management: 10 years of experience in a large integrated health care system. J Manag Care Pharm. 2010 Apr;16(3):185-95. doi: 10.18553/jmcp.2010.16.3.185. |
| 16219897 | Background | Benrimoj SI, Roberts AS. Providing patient care in community pharmacies in Australia. Ann Pharmacother. 2005 Nov;39(11):1911-7. doi: 10.1345/aph.1G165. Epub 2005 Oct 11. |
| 31638909 | Background | Beuscart JB, Petit S, Gautier S, Wierre P, Balcaen T, Lefebvre JM, Kambia N, Bertoux E, Mascaut D, Barthelemy C, Cuny D, Puisieux F, Decaudin B. Polypharmacy in older patients: identifying the need for support by a community pharmacist. BMC Geriatr. 2019 Oct 21;19(1):277. doi: 10.1186/s12877-019-1276-y. |
| 38635115 | Derived | Christopher CM, Blebil AQ, Bhuvan KC, Alex D, Ibrahim MIM, Ismail N, Cheong MWL. Assessing feasibility of conducting medication review with follow-up among older adults at community pharmacy: a pilot randomised controlled trial. Int J Clin Pharm. 2024 Aug;46(4):843-853. doi: 10.1007/s11096-024-01711-3. Epub 2024 Apr 18. |