Universität zu Köln

Koeberlein-Neu, Juliane ORCID: 0000-0002-3451-7847, Mennemann, Hugo, Hamacher, Stefanie ORCID: 0000-0003-2158-9101, Waltering, Isabel, Jaehde, Ulrich, Schaffert, Corinna and Rose, Olaf (2016). Interprofessional Medication Management in Patients With Multiple Morbidities A Cluster-randomized Trial (the WestGem Study). Dtsch. Arztebl. Int., 113 (44). S. 741 - 757. COLOGNE: DEUTSCHER AERZTE-VERLAG GMBH. ISSN 1866-0452

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Abstract

Background: Medication reviews and medication management are being used more and more around the world to improve medication safety. Both of these tools were originally conceived as pharmaceutical care activities and have recently been developed into interdisciplinary approaches. We studied the efficacy of interprofessional medication management for multimorbid patients that takes their medical conditions, but also their general living situation into account. Methods: A comprehensive medication management was performed, which involved the collection of information on the drugs each patient took, the way they were stored, the patient's drug intake and handling, and any problems that arose with pharmacotherapy. The interventional approach was evaluated over a period of 15 months in a cluster-randomized controlled trial with a stepped wedge design. The primary endpoint was the quality of pharmacotherapy, as assessed with the Medication Appropriateness Index (MAI). A mixed model was used to analyze efficacy. Results: 162 patients were enrolled in the study; 142 were included in the intention-to-treat analysis (53.3% women, mean age 76.8 +/- 6.3 years). The mean total MAI score decreased significantly (p <= 0.001) from the control phase (29.21, 95% CI [26.09; 32.33]) to the intervention phase (22.27 [19.00; 25.54]), with an effect strength (Cohen's d) of -0.24 [-0.36; -0.13]. The number of drug-related problems declined as well. Conclusion: In this study, interprofessional collaboration increased medication safety. Working across disciplinary boundaries allowed for a decrease in drug-related problems and brought up aspects outside the purview of the primary care physician.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Koeberlein-Neu, Juliane UNSPECIFIED orcid.org/0000-0002-3451-7847 UNSPECIFIED Mennemann, Hugo UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamacher, Stefanie UNSPECIFIED orcid.org/0000-0003-2158-9101 UNSPECIFIED Waltering, Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Jaehde, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaffert, Corinna UNSPECIFIED UNSPECIFIED UNSPECIFIED Rose, Olaf UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-255858
DOI:	10.3238/arztebl.2016.0741
Journal or Publication Title:	Dtsch. Arztebl. Int.
Volume:	113
Number:	44
Page Range:	S. 741 - 757
Date:	2016
Publisher:	DEUTSCHER AERZTE-VERLAG GMBH
Place of Publication:	COLOGNE
ISSN:	1866-0452
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language THERAPY MANAGEMENT; COMMUNITY PHARMACISTS; APPROPRIATENESS INDEX; CARE; INTERVENTIONS; ILLNESS; ISSUES Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/25585