Evidence map›Paper›PMID 29548304›Full record

Trial reportBMC geriatrics2018

Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness.

Terhi Toivo, Maarit Dimitrow, Juha Puustinen, Eeva Savela, Katariina Pelkonen, Valtteri Kiuru, Tuula Suominen, Sirkka Kinnunen, Mira Uunimäki, Sirkka-Liisa Kivelä and 2 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC geriatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02545257 (Development of a Coordinated, Community-Based Medication Management Model for Home-Dwelling Aged in Primary Care), which is not on this map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
2.6field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02545257 nacompletednot on this map

Development of a Coordinated, Community-Based Medication Management Model for Home-Dwelling Aged in Primary Care

TypeinterventionalSponsorUniversity of HelsinkiRan2015 to 2018Enrolled191ConditionsDrug Therapy, Combination, Inappropriate Prescribing, PolypharmacyArmsCoordinated medication management model
3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.

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  17. Medication Risk Management in Routine Dispensing in Community Pharmacies.International journal of environmental research and public health · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Terhi ToivoFaculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, Clinical Pharmacy Group, University of Helsinki, Viikinkaari 5 E, P.O. BOX 56, 00014, Helsinki, Finland. terhi.toivo@helsinki.fi.ORCID 0000-0001-8357-2714
Maarit DimitrowFaculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, Clinical Pharmacy Group, University of Helsinki, Viikinkaari 5 E, P.O. BOX 56, 00014, Helsinki, Finland.
Juha PuustinenFaculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, Clinical Pharmacy Group, University of Helsinki, Viikinkaari 5 E, P.O. BOX 56, 00014, Helsinki, Finland.
Eeva Savela1st Pharmacy of Lohja, Laurinkatu 37-41 A, 08100, Lohja, Finland.
Katariina PelkonenCity of Lohja, Services for Aged Residents, PL 71, 08101, Lohja, Finland.
Valtteri KiuruCity of Lohja, Services for Aged Residents, PL 71, 08101, Lohja, Finland.
Tuula SuominenCity of Lohja, Services for Aged Residents, PL 71, 08101, Lohja, Finland.
Sirkka KinnunenCity of Lohja, Services for Aged Residents, PL 71, 08101, Lohja, Finland.
Mira UunimäkiCity of Lohja, Services for Aged Residents, PL 71, 08101, Lohja, Finland.
Sirkka-Liisa KiveläFaculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, Clinical Pharmacy Group, University of Helsinki, Viikinkaari 5 E, P.O. BOX 56, 00014, Helsinki, Finland.
Saija Leikola1st Pharmacy of Lohja, Laurinkatu 37-41 A, 08100, Lohja, Finland.
Marja AiraksinenFaculty of Pharmacy, Division of Pharmacology and Pharmacotherapy, Clinical Pharmacy Group, University of Helsinki, Viikinkaari 5 E, P.O. BOX 56, 00014, Helsinki, Finland.
University of Helsinki · FI

Funding

the Association of Finnish Pharmacies research grant for PhD thesis, year 2016the Social Insurance Institution (SII), Finland 46/26/2014
6 · The paper itself

Abstract

backgroundThe magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure.

methodsHealth care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy. System based risk management theory and action research method was applied to construct the collaborative procedure utilizing each profession's existing resources in medication risk management of older home care clients. An inventory of clinical measures in usual clinical practice and systematic review of rigorous study designs was utilized in effectiveness study design. DISCUSSION: The new coordinated medication management model (CoMM) has the following 5 stages: 1) practical nurses are trained to identify clinically significant drug-related problems (DRPs) during home visits and report those to the clinical pharmacist. Clinical pharmacist prepares the cases for 2) an interprofessional triage meeting (50-70 cases/meeting of 2 h) where decisions are made on further action, e.g., more detailed medication reviews, 3) community pharmacists conduct necessary medication reviews and each patients' physician makes final decisions on medication changes needed. The final stages concern 4) implementation and 5) follow-up of medication changes. Randomized controlled trial (RCT) was developed to demonstrate the effectiveness of the procedure. The developed procedure is feasible for screening and reviewing medications of a high number of older home care clients to identify clients with severe DRPs and provide interventions to solve them utilizing existing primary care resources.

trial registrationThe study is registered in the Clinical Trials.gov ( NCT02545257 ). Registration date September 9 2015.

Indexed as

AgedFemaleFinlandHealth ResourcesHome Care ServicesHumansMaleMedication ReconciliationPharmacistsPrimary Health CareProspective StudiesRisk ManagementTreatment OutcomeCoordinated procedureHome careMedication risk managementOlder adultsRandomized controlled trial

Identifiers

PMID29548304
PMCPMC5857129
OpenAlexW2789670490

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.