Evidence map›Paper›PMID 34404698›Full record

ArticleBMJ open2021

Reducing risks associated with medicines and lifestyle in a residential care population with intellectual disabilities: evaluation of a pharmacy review initiative in England.

Nick Thayer, Simon White, Jasmeen Islam, Wesley Jones, Stephanie Kenzie, Rajni Kullu

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 38% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Review
  6. Review
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

6 authors at 2 institutions in 1 country.

Nick ThayerSchool of Pharmacy and Bioengineering, Keele University, Newcastle-under-Lyme, Staffordshire, UK n.m.thayer@keele.ac.uk.ORCID 0000-0003-1127-9433
Simon WhiteSchool of Pharmacy and Bioengineering, Keele University, Newcastle-under-Lyme, Staffordshire, UK.ORCID 0000-0003-0096-251X
Jasmeen IslamCheshire and Wirral Partnership NHS Foundation Trust, Chester, Cheshire West and Chester, UK.ORCID 0000-0002-8828-5738
Wesley JonesCommunity Pharmacy Cheshire and Wirral, Runcorn, Cheshire West and Chester, UK.
Stephanie KenzieCheshire and Wirral Partnership NHS Foundation Trust, Chester, Cheshire West and Chester, UK.
Rajni KulluCheshire and Wirral Partnership NHS Foundation Trust, Chester, Cheshire West and Chester, UK.
Cheshire West and Chester · GBKeele University · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesA collaborative service initiative involving community pharmacists and a specialist mental health pharmacist was developed to provide pharmacist reviews for care home residents with intellectual disabilities (IDs). This study aimed to characterise the medicines and lifestyle risk outcomes of the service and determine how these align with national priority issues in ID.

designDescriptive statistical analysis of routinely collected service delivery data.

settingResidential care homes in the Wirral, England for people with ID.

participants160 residents.

interventionsPharmacist review of residents' medicines and lifestyle risk factors between November 2019 and May 2020. PRIMARY AND SECONDARY OUTCOME MEASURES: Numbers of medicines prescribed, the nature of pharmacists' interventions/recommendations and general practitioner (GP)/psychiatrist acceptance.

resultsThe 160 residents were prescribed 1207 medicines, 74% were prescribed ≥5 medicines and 507 interventions/recommendations were made, averaging 3.3 per resident. The highest proportion (30.4%) were lifestyle risk related, while changing and stopping medicines accounted for 17.9% and 12.8%, respectively. Of the recommendations discussed with GPs/psychiatrists, 86% were accepted. Medicines with anticholinergic properties were prescribed for 115 (72%) residents, of whom 43 (37%) had a high anticholinergic burden score. Pharmacists recommended anticholinergic discontinuation or dose reduction for 28 (24%) residents. The pharmacists made interventions/recommendations about constipation management for 10% of residents and about respiratory medicines for 17 (81%) of the 21 residents with respiratory diagnoses.

conclusionsThe findings indicate considerable polypharmacy among the residents and a high level of pharmacists' interventions/recommendations about medicines and lifestyle risk, most of which were accepted by GPs/psychiatrists. This included anticholinergic burden reduction and improving respiratory disease and constipation management, which are national priority issues. Wider adoption of collaborative pharmacist review models could have similar benefits for residential populations with ID and potentially reduce pressure on other health services.

Indexed as

Intellectual DisabilityPharmaceutical ServicesPharmacyHumansLife StylePharmacistsadult psychiatrymental healthprimary care

Identifiers

PMID34404698
PMCPMC8372807
OpenAlexW3194837763

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

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.