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Value of a Community‐Based Medication Management Review Service in Jordan: A Prospective Randomized Controlled Study
Author(s) -
Basheti Iman A.,
Tadros Odate K. I.,
Aburuz Salah
Publication year - 2016
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1002/phar.1833
Subject(s) - value (mathematics) , randomized controlled trial , medicine , statistics , mathematics
Study Objective To assess the impact of a medication management review ( MMR ) service on treatment‐related problems ( TRP s) and certain clinical outcomes in outpatients. Design Prospective randomized controlled study. Setting Two community pharmacies in Amman, Jordan. Patients A total of 160 people who visited the two community pharmacies between September 2009 and June 2010. Intervention Patients were randomized into two groups: intervention (82 patients) and control (78 patients) groups. The clinical pharmacist conducted a baseline assessment MMR for patients in both groups to determine the prevalence and type of TRP s; however, recommendations regarding the identified TRP s were only submitted to the physicians of patients in the intervention group. Measurements and Main Results All patients were followed for an average of 3.39 months after their baseline visit to the pharmacy. The impact of the MMR service for the intervention group was assessed by evaluating the outcomes of the recommendations submitted by the clinical pharmacist to resolve the identified TRP s, physicians' acceptance of the recommended interventions, and the effect of the intervention on certain clinical outcomes: blood glucose levels, blood pressure, and triglyceride levels. Follow‐up assessment of the control group included evaluating the outcomes of the identified TRP s (identified and corrected by physicians without any input from the clinical pharmacist) and comparing glucose level, blood pressure, and triglyceride‐level results with baseline values. No significant differences in mean number of medical conditions (3.7 vs 3.42, p=0.134), mean number of medications (4.51 vs 4.96, p=0.135), or mean number of TRP s per patient (5.55 vs 5.17, p=0.42) were observed at baseline in the intervention group versus the control group. Follow‐up results revealed a high acceptance rate of recommendations by the physicians (94%). Regarding outcomes of TRP s, almost 70% of the identified TRP s in the intervention group were resolved or improved compared with 2% in the control group (p<0.001). Significant differences were found between the intervention group versus control group with regard to mean ± SD glucose levels (99.08 ± 9.66 vs 115.48 ± 17.34, p<0.001), blood pressure (110.36/81.55 ± 9.45/3.91 vs 125.0/88.73 ± 10.34/4.12, p<0.001), and triglyceride levels (148.53 ± 15.98 vs 170.74 ± 6.26, p=0.001). Conclusion The MMR service resulted in a significantly lower number of TRP s and significantly improved clinical outcomes, and it was highly accepted by the physicians.