The effect of a comprehensive, interdisciplinary medication review on quality of life and medication use in community dwelling older people with polypharmacy

  • Background: We conducted a comprehensive medication review at the patients’ home, using data from electronic patient records, and with input from relevant specialists, general practitioners and pharmacists formulated and implemented recommendations to optimize medication use in patients aged 60+ years with polypharmacy. We evaluated the effect of this medication review on quality of life (QoL) and medication use. Methods: Cluster randomized controlled trial (stepped wedge), randomly assigning general practices to one of three consecutive steps. Patients received usual care until the intervention was implemented. Primary outcome was QoL (SF-36 and EQ-5D); secondary outcomes were medication changes, medication adherence and (instrumental) activities of daily living (ADL, iADL) which were measured at baseline, and around 6- and 12-months post intervention. Results: Twenty-four general practices included 360 women and 410 men with an average age of 75 years (SD 7.5). A positive effect on SF-36 mental health (estimated mean was stable in the intervention, but decreased in the control condition with −6.1, p = 0.009,) was found with a reduced number of medications at follow-up compared to the control condition. No significant effects were found on other QoL subscales, ADL, iADL or medication adherence. Conclusion: The medication review prevented decrease of mental health (SF36), with no significant effects on other outcome measures, apart from a reduction in the number of prescribed medications.

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Author:Donna Bosch-Lenders, Jesse Jansen, Henri E. J. H. Stoffers, Bjorn Winkens, Karin Aretz, Mascha Twellaar, Jos M. G. A. Schols, Paul-Hugo Marie van der Kuy, J. André Knottnerus, Marjan van den AkkerORCiDGND
Parent Title (English):Journal of Clinical Medicine
Place of publication:Basel
Document Type:Article
Date of Publication (online):2021/02/05
Date of first Publication:2021/02/05
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/07/21
Tag:cluster-randomized controlled trial; general practitioner; home visit; medication review; patient; pharmacist; polypharmacy; primary care
Issue:4, art. 600
Page Number:14
First Page:1
Last Page:14
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0