Non-adherence to multiple medications (i.e. polypharmacy) in older adults Not Applicable
Conditions
Interventions
The S-MAP intervention will be targeted at older patients aged 65 years or older who are prescribed multiple medications (polypharmacy) to improve their adherence to agreed recommendations. In the cur
6 community pharmacies in England (greater London area) and 6 community pharmacies in Northern Ireland. Pharmacist training, developed in conjunction with experts in health psychology, will consist of
Sponsors
Queen's University Belfast
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Community pharmacist participants: 1. Must be registered as a pharmacist with the Pharmaceutical Society of Northern Ireland or The General Pharmaceutical Council 2. The pharmacist must be employed and regularly work at the study pharmacy site (i.e. not a locum pharmacist) 3. The pharmacy in which they work must a registered pharmacy located in Northern Ireland or greater London area (England) 4. The pharmacy in which they work must have a private consultation room/area, access to WiFi internet and printing facilities Pharmacy support staff participants: 1. Pharmacy support staff involved in the study must have completed an accredited Medicines Counter Assistant course or equivalent (as a minimum) Patient participants: 1. Aged 65 years or older 2. Prescribed four or more regular medications (excluding medications prescribed to be taken only when required) 3. Living in their own home 4. Have at least 12 months of dispensing data available from the time of eligibility screening (on the pharmacy-held Patient Medication Record) 5. Only attend the study site pharmacy for regular medications 6. Have an identified adherence problem (detected using a validated self-report adherence questionnaire)
Exclusion criteria
Exclusion criteria: Community pharmacists: 1. Not meeting the eligibility criteria 2. Not providing written informed consent 3. Previous participation in the feasibility study (conducted only in Northern Ireland; ISRCTN17966504) Pharmacy support staff: 1. Not meeting the eligibility criteria 2. Not providing written informed consent Patient participants: 1. Not meeting the eligibility criteria 2. Not providing written informed consent 3. Prescribed medications for the treatment or management of dementia (e.g. donepezil, galantamine, rivastigmine or memantine) 4. Unable to complete the self-report adherence screening questionnaire
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Medication adherence, measured using the following two approaches: 1. Refill/dispensing data (objective): patient records held in the community pharmacy will provide details of medications dispensed in the 12 months pre-baseline and 12 months post-baseline (i.e. pre-session 1). These data will be used to calculate the Medication Possession Ratio (MPR) and Daily Polypharmacy Possession Ratio (DPPR). 2. Self-report (subjective): adherence will be measured using two validated measures (Medication Adherence Rating Scale- 5 item (MARS-5) and a 1-item self-rating of ability scale developed by Lu et al.) at baseline (eligibility screening stage), 6 months post-baseline and 12 months post-baseline. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Health-related quality of life (HRQOL) measured via self-report using the EQ-5D-5L at baseline (pre-session 1) and 6 and 12 months from baseline 2. Unplanned hospitalisations (resulting in an overnight stay in hospital) in the previous six months measured via self-report at baseline (pre-session 1) and 6 and 12 months from baseline. The feasibility of collecting data from GP surgeries on unplanned hospitalisations to verify self-report data | — |
Countries
United Kingdom
Outcome results
None listed