Evidence map›Paper›PMID 38042778›Full record

ArticleBMC primary care2023

Clinical impact of medication reviews for community-dwelling patients in primary healthcare.

Annika Dobszai, Cecilia Lenander, Beata Borgström Bolmsjö, Katarina Wickman, Sara Modig

Abstract read
In one paragraph

Article in BMC primary care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
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

4 citing papers in PubMed.

  1. Article
  2. Article
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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

5 authors.

Annika DobszaiCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden. Annika.Dobszai@med.lu.se.ORCID 0000-0003-2689-7429
Cecilia LenanderCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.ORCID 0000-0003-0553-7432
Beata Borgström BolmsjöCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.ORCID 0000-0001-7655-0613
Katarina WickmanCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.ORCID 0000-0002-4492-1894
Sara ModigCenter for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.ORCID 0000-0001-7775-4482

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA high number of drug-related problems has previously been shown among community-dwelling patients in primary healthcare in Skåne County, Sweden. Medication reviews are one way to solve these problems, but their impact is largely dependent on the process. We aimed to evaluate medication reviews for community-dwelling patients regarding the clinical relevance of the pharmacists' recommendations, and their implementation by general practitioners. We also wanted to investigate if the general practitioners' tendency to act on drug-related problems was correlated to different factors of the process.

methodsThis was a cohort study, where patients in primary healthcare considered in need of a medication review were selected. Pharmacists identified drug-related problems and gave written recommendations on how to solve the problems to the general practitioner, via the medical record, and in addition in some cases via verbal communication. The clinical relevance of the recommendations was graded according to the Hatoum scale, ranging from one (adverse significance) to six (extremely significant). Descriptive statistics were used regarding the clinical relevance and the general practitioners´ tendency to act on drug-related problems. Multiple logistic regression analysis was used to examine the association between the tendency to act and different factors of the process.

resultsA total of 96.1% of the 384 assessed recommendations from the pharmacists were graded as significant or more for the patient (Hatoum grade 3 or higher). The general practitioners acted on 63.8% of the drug-related problems. Fewer recommendations per patient, as well as verbal communication in addition to written contact, significantly increased the general practitioners' tendency to act on a drug-related problem. No significant association was seen between the tendency to act and the clinical relevance of the recommendation.

conclusionsThe high proportion of clinically relevant recommendations from the pharmacists in this study strengthens medication reviews as an important tool for reducing drug-related problems. Verbal communication between the pharmacist and the general practitioner is important for measures to be taken. Multiple recommendations for the same patient reduced their likelihood to of being addressed by the general practitioner.

Indexed as

General PractitionersMedication ReviewCohort StudiesHumansIndependent LivingPrimary Health CareClinical relevanceDrug-related problemIndependent livingMedication reviewPharmacist, clinicalPolypharmacyPrimary healthcare

Identifiers

PMID38042778
PMCPMC10693162

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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.