Beliefs About Medicines, Health-related Quality of Life, Medication-related Problems, Self-reported Medication Adherence
Conditions
Keywords
Telemedicine, Medication reconciliation, Clinical pharmacist, Adherence, Telepharmacy, Medication-related problems, Aged, Structured medication review
Brief summary
In this study, a telepharmacy service in primary care for home-living older adults in Northern Sweden's rural areas will be developed and evaluated. The primary objective is to evaluate the effect of the service regarding the identification, classification, and resolution of medication-related problems (MRPs). Secondary objectives are to evaluate participants' medication adherence, health-related quality of life, and beliefs about medicines through self-report questionnaires. The telepharmacy service include medication interviews, structured medication reviews, interdisciplinary patient-centred discussions, and follow-ups.
Detailed description
Participants that meet the inclusion criteria will be invited to participate in the study via mail. The participants will also receive three validated questionnaires; Medication Adherence Report Scale-5 (MARS-5), EuroQol-5 Dimension-5 Level questionnaire (EQ-5D-5L) and The Beliefs about Medicines Questionnaire (BMQ) to fill in prior to initiation of the study, to collect baseline data. The intervention consists of several steps, and all meetings will be conducted through video conferencing via a secure virtual care platform. Initially, the participant will have a medication interview with a clinical pharmacist, Next, the clinical pharmacist conducts a structured medication review based on information from the interview and the participant's medical records and laboratory values. The clinical pharmacist and the participant's primary care physician will then have a video-based interdisciplinary meeting. During this meeting, the clinical pharmacist presents recommendations to resolve potential MRPs, and the physician may accept or reject the pharmacist's recommendations. The primary-care physician informs the participant about any changes in their medication therapy and follows-up and monitors these changes. Video-based follow-up meetings between the participant and the clinical pharmacist will take place 1-2, 4 and 12 weeks after the first video-based meeting. Additional meetings can be scheduled, if requested by the participant, or if considered necessary by the clinical pharmacist. The clinical pharmacist will also conduct medical record reviews once every two weeks during the 12-week intervention period. At 12 weeks, after the last follow-up, the participant will be asked to fill in the three questionnaires one more time.
Interventions
OTHERTelepharmacy service
Video-based medication interviews, structured medication reviews, interdisciplinary patient-centred discussions, follow-ups
Sponsors
Umeå University
Region Västerbotten
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Using five or more prescribed medications and/or considered as a potential candidate by the primary care physician. * Living at home (i.e not in a nursing home) * Registered at primary healthcare centres in rural municipalities within Västerbotten County (and neighbouring counties if necessary)
Exclusion criteria
* Do not speak Swedish * Unable to communicate * Has a confirmed major neurocognitive disorder * Receives palliative care
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Identification and classfication of medication-related problems | The 12-week intervention period | Classification of mediation-related problems according to a modified version of the classification system by Cipolle et al (1998). |
| Resolution of medication-related problems | 12-week intervention period | The clinical pharmacists' recommendations to resolve medication-related problems will be classified according to a modified version of a system developed by the French Society of Clinical pharmacy. Physicians' acceptance rate of pharmacists' recommendations will be classified. The acceptance rate will be classified as accepted recommendation, rejected recommendation, or unknown. |
| Intra-individual change in self-reported medication adherence: Medication Adherence Report Scale-5 (MARS-5) | Baseline and 12 weeks | Assessing self-reported medication adherence through the MARS-5 questionnaire. Total score ranging between 5 and 25, with higher scores indicating a higher level of medication adherence. |
| Intra-individual change in self-reported health-related quality of life: EuroQol-5 Dimension-5 Level questionnaire (EQ-5D-5L) | Baseline and 12 weeks | Assessing health-related quality of life through the EQ-5D-5L-questionnaire. The questionnaire consists of five questions regarding self-perceived quality of life, and a visual analogue scale on which the respondents evaluate their own health status on a scale of 0-100. |
| Intra-individual change in self-reported beliefs about medicines: The Beliefs about Medicines Questionnaire (BMQ) | Baseline and 12 weeks | Assessing beliefs about medicines through the BMQ. The questionnaire consists of two different scales; BMQ-General assesses the respondent's beliefs about medicines in general and BMQ-Specific evaluates the individual's beliefs about medicines prescribed for their own use. |
Countries
Sweden
Contacts
PRINCIPAL_INVESTIGATORMaria Gustafsson, Ph.D
Department of Medical and Translational Biology, Umeå University
Outcome results
None listed