Universität zu Köln

Rose, Olaf, Schaffert, Corinna, Czarnecki, Kathrin, Mennemann, Hugo S., Waltering, Isabel, Hamacher, Stefanie ORCID: 0000-0003-2158-9101, Felsch, Moritz, Herich, Lena and Koeberlein, Juliane (2015). Effect evaluation of an interprofessional medication therapy management approach for multimorbid patients in primary care: a cluster-randomized controlled trial in community care (WestGem study protocol). BMC Fam. Pract., 16. LONDON: BMC. ISSN 1471-2296

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Abstract

Background: Pharmaceutical practice worldwide is developing towards patient care. Medication Review (MR) and Medication Therapy Management (MTM) are evolving as the most prominent services in pharmaceutical care and have a strong potential to provide a large benefit for patients and society. MTMs can only be performed in an interprofessional, collaborative setting. Several international studies have explored the effects of a MTM on the quality of therapy and costs. For Germany the data is still deficient. This study aims to provide data on the effects of an interprofessional MTM regarding quality of therapy, quality of life, costs and cost-effectiveness. Method/Design: The study is designed as a cluster-randomized controlled trial in primary care, involving 12 outpatient clinics (clusters) and 165 patients. Primary care units are allocated to interventions using a Stepped Wedge Design. All units are initially assigned to the control group. After a 6 month observation period, general practitioners (GP) are randomly allocated to one of three groups and the interprofessional medication therapy management approach is implemented sequentially per each group with a lag of 3 months between. The primary outcome is the change in the quality of therapy measured by the MAI (Medication Appropriateness Index). Secondary outcomes include changes in the number of drug related problems, medication complexity, changes in drug-adherence, changes in health-status and function, quality of life, direct costs and the incremental cost-effectiveness ratio. The acceptance of the interprofessional Medication Therapy Management approach is assessed by qualitative methods. Discussion: The patient interview and brown bag review are activities, typically provided by the pharmacist. In this trial the patient is blinded to the pharmacist. The strength of having the patient blinded to the pharmacists is to exclude skepticism of the patient toward unknown pharmacies, which might be a major confounder in a regional and community setting. A weakness is that some patient related data might reach the pharmacists in a way, which might differ from self-acquired data.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rose, Olaf UNSPECIFIED UNSPECIFIED UNSPECIFIED Schaffert, Corinna UNSPECIFIED UNSPECIFIED UNSPECIFIED Czarnecki, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mennemann, Hugo S. 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 Koeberlein, Juliane UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-398681
DOI:	10.1186/s12875-015-0305-y
Journal or Publication Title:	BMC Fam. Pract.
Volume:	16
Date:	2015
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2296
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PHARMACEUTICAL CARE; COLLABORATIVE APPROACH; COMPLEX INTERVENTIONS; APPROPRIATENESS INDEX; RESPONSE RATES; PHARMACY CARE; ADHERENCE; SERVICES; PROGRAM; QUALITY Multiple languages Primary Health Care; Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/39868