Universität zu Köln

Rose, Olaf, Mennemann, Hugo, John, Carina, Lautenschlaeger, Marcus, Mertens-Keller, Damaris, Richling, Katharina, Waltering, Isabel, Hamacher, Stefanie ORCID: 0000-0003-2158-9101, Felsch, Moritz, Herich, Lena, Czarnecki, Kathrin, Schaffert, Corinna, Jaehde, Ulrich and Koeberlein-Neu, Juliane ORCID: 0000-0002-3451-7847 (2016). Priority Setting and Influential Factors on Acceptance of Pharmaceutical Recommendations in Collaborative Medication Reviews in an Ambulatory Care Setting - Analysis of a Cluster Randomized Controlled Trial (WestGem-Study). PLoS One, 11 (6). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

Background Medication reviews are recognized services to increase quality of therapy and reduce medication risks. The selection of eligible patients with potential to receive a major benefit is based on assumptions rather than on factual data. Acceptance of interprofessional collaboration is crucial to increase the quality of medication therapy. Objective The research question was to identify and prioritize eligible patients for a medication review and to provide evidence-based criteria for patient selection. Acceptance of the prescribing general practitioner to implement pharmaceutical recommendations was measured and factors influencing physicians' acceptance were explored to obtain an impression on the extent of collaboration in medication review in an ambulatory care setting. Methods Based on data of a cluster-randomized controlled study (WestGem-study), the correlation between patient parameters and the individual performance in a medication review was calculated in a multiple logistic regression model. Physician's acceptance of the suggested intervention was assessed using feedback forms. Influential factors were analyzed. Results The number of drugs in use (p = 0.001), discrepancies between prescribed and used medicines (p = 0.014), the baseline Medication Appropriateness Index score (p<0.001) and the duration of the intervention (p = 0.006) could be identified as influential factors for a major benefit from a medication review, whereas morbidity (p>0.05) and a low kidney function (p>0.05) do not predetermine the outcome. Longitudinal patient care with repeated reviews showed higher interprofessional acceptance and superior patient benefit. A total of 54.9% of the recommendations in a medication review on drug therapy were accepted for implementation. Conclusions The number of drugs in use and medication reconciliation could be a first rational step in patient selection for a medication review. Most elderly, multimorbid patients with polymedication experience a similar chance of receiving a benefit from a medication review. Longitudinal patient care should be preferred over confined medication reviews. The acceptance of medication reviews by physicians supports further implementation into health care systems.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rose, Olaf UNSPECIFIED UNSPECIFIED UNSPECIFIED Mennemann, Hugo UNSPECIFIED UNSPECIFIED UNSPECIFIED John, Carina UNSPECIFIED UNSPECIFIED UNSPECIFIED Lautenschlaeger, Marcus UNSPECIFIED UNSPECIFIED UNSPECIFIED Mertens-Keller, Damaris UNSPECIFIED UNSPECIFIED UNSPECIFIED Richling, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Waltering, Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamacher, Stefanie UNSPECIFIED orcid.org/0000-0003-2158-9101 UNSPECIFIED Felsch, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Herich, Lena UNSPECIFIED UNSPECIFIED UNSPECIFIED Czarnecki, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaffert, Corinna UNSPECIFIED UNSPECIFIED UNSPECIFIED Jaehde, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Koeberlein-Neu, Juliane UNSPECIFIED orcid.org/0000-0002-3451-7847 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-272534
DOI:	10.1371/journal.pone.0156304
Journal or Publication Title:	PLoS One
Volume:	11
Number:	6
Date:	2016
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DRUG-RELATED PROBLEMS; THERAPY MANAGEMENT SERVICES; ILLNESS RATING-SCALE; APPROPRIATENESS INDEX; PHARMACIST INTERVENTIONS; COMMUNITY PHARMACIES; DIABETES-MELLITUS; PATIENT OUTCOMES; ELDERLY-PATIENTS; ADHERENCE Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27253