Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis

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 pharma...

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Autores principales:	Christina Malini Christopher, Bhuvan KC, Ali Blebil, Deepa Alex, Mohamed Izham Mohamed Ibrahim, Norhasimah Ismail, Alian A. Alrasheedy
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	community pharmacy intervention older adults outcomes systematic review Medicine R
Acceso en línea:	https://doaj.org/article/8559bbc18fcf4324b9369a20e80b8082
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spelling	oai:doaj.org-article:8559bbc18fcf4324b9369a20e80b80822021-11-25T17:46:33ZClinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis10.3390/healthcare91115772227-9032https://doaj.org/article/8559bbc18fcf4324b9369a20e80b80822021-11-01T00:00:00Zhttps://www.mdpi.com/2227-9032/9/11/1577https://doaj.org/toc/2227-9032This 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%, <i>p</i> < 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%, <i>p</i> = 0.36) and require hospitalization (risk ratio 0.72; 95% CI (0.47, 1.12) I2 = 45%, <i>p</i> = 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.Christina Malini ChristopherBhuvan KCAli BlebilDeepa AlexMohamed Izham Mohamed IbrahimNorhasimah IsmailAlian A. AlrasheedyMDPI AGarticlecommunity pharmacyinterventionolder adultsoutcomessystematic reviewMedicineRENHealthcare, Vol 9, Iss 1577, p 1577 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	community pharmacy intervention older adults outcomes systematic review Medicine R
spellingShingle	community pharmacy intervention older adults outcomes systematic review Medicine R Christina Malini Christopher Bhuvan KC Ali Blebil Deepa Alex Mohamed Izham Mohamed Ibrahim Norhasimah Ismail Alian A. Alrasheedy Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis
description	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%, <i>p</i> < 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%, <i>p</i> = 0.36) and require hospitalization (risk ratio 0.72; 95% CI (0.47, 1.12) I2 = 45%, <i>p</i> = 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.
format	article
author	Christina Malini Christopher Bhuvan KC Ali Blebil Deepa Alex Mohamed Izham Mohamed Ibrahim Norhasimah Ismail Alian A. Alrasheedy
author_facet	Christina Malini Christopher Bhuvan KC Ali Blebil Deepa Alex Mohamed Izham Mohamed Ibrahim Norhasimah Ismail Alian A. Alrasheedy
author_sort	Christina Malini Christopher
title	Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis
title_short	Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis
title_full	Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis
title_fullStr	Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis
title_full_unstemmed	Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis
title_sort	clinical and humanistic outcomes of community pharmacy-based healthcare interventions regarding medication use in older adults: a systematic review and meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/8559bbc18fcf4324b9369a20e80b8082
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Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis

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