Impact of a DSS-supported medication review on the safety of drug therapy and quality of life in patients with antithrombotic therapy
Polypharmacy is common among patients with antithrombotic medication, giving rise to concerns about Drug-Related Problems (DRPs). Therefore, these patients would benefit from a Medication Review (MR) along with pharmacist counselling to reduce the risks accompanying polymedication. This prospecti...
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| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Philipps-Universität Marburg
2024
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| Subjects: | |
| Online Access: | PDF Full Text |
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| Summary: | Polypharmacy is common among patients with antithrombotic medication,
giving rise to concerns about Drug-Related Problems (DRPs). Therefore, these
patients would benefit from a Medication Review (MR) along with pharmacist
counselling to reduce the risks accompanying polymedication. This prospective
study presents a concept for MRs that are applicable in German community
pharmacies and can efficiently support pharmacist counselling and improve the
safety of drug therapy. As this is a major challenge in everyday pharmacy practice,
we used a Decision Support System (DSS) to evaluate its ability to support the
process of pharmacist-led MRs. The primary endpoint was the impact of a
community pharmacist on the reduction of DRPs. We investigated the impact
of the interventions resulting from MRs on patients taking at least one
antithrombotic drug as part of their polymedication regimen. Secondary
endpoints were the reduction in the number of patients with bleeding risks
and the improvement of patients’ Quality of Life (QoL) and therapy adherence.
Furthermore, the DSS used in the study was controlled for correct data
assessment and plausibility of data. We selected adult patients who were
taking no less than three different medications for long-term treatment, at
least one of which had to be an antithrombotic drug, and who were
customers in one of eight selected pharmacies over a period of 6 months.
Data from 87 patients were analyzed with DSS-support. A total of 234 DRPs
were identified by the pharmacist (2.7 DRPs per patient). MR reduced DRPs by
43.2% which, resulting to a reduction of 1.2 DRPs per patient. The intervention
also led to a significant improvement in the patients’ QoL (assessed via EQ-5D-5L
questionnaire; p < 0.001) and enhanced therapy adherence (assessed via
A14 questionnaire; p < 0.001). The control of correct data assessment (with
93.8% concordance) and plausibility of data (with 91.7% concordance) of the DSS
software were conducted by an external auditor. No significant effect was found
for overall bleeding risk. The results of this study indicate that DSS-supported and
structured MR conducted by pharmacists can contribute to a reduction in DRPs
and significantly improve patient’s QoL and adherence to treatment. |
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| Item Description: | Gefördert durch den Open-Access-Publikationsfonds der UB Marburg. |
| DOI: | 10.3389/fphar.2024.1194201 |