Epidemiol Health.  2019;41:e2019020. 10.4178/epih.e2019020.

Impact of pharmacist-led home medicines review services on drug-related problems among the elderly population: a systematic review

Affiliations
  • 1Rady Faculty of Health Sciences, University of Manitoba College of Pharmacy, Winnipeg, Canada. sknanu06@gmail.com
  • 2Department of Pharmacy Practice, Sarada Vilas College of Pharmacy, Mysuru, India.
  • 3Department of Pharmacy Practice, Indo-Soviet Friendship College of Pharmacy, Moga, India.
  • 4Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, Bala Gangadharanatha Nagara, Karnataka, India.
  • 5Department of Physiotherapy and Rehabilitation Sciences, Jagadguru Sri Shivarathreeshwara, College of Physiotherapy, Rajiv Gandhi University of Health Sciences, Karnataka, India.

Abstract


OBJECTIVES
To address and elucidate the impact of pharmacist-led home medicines review (HMR) services on identifying drug-related problems (DRPs) among the elderly population in home care settings.
METHODS
A comprehensive systematic search was performed using electronic scientific databases such as PubMed, Scopus, Embase, and Web of Science for studies published between January 1, 2008 and December 31, 2018, pertaining to HMR services by pharmacists for identifying DRPs.
RESULTS
In total, 4,292 studies were retrieved from the searches, of which 24 were excluded as duplicates. Titles and abstracts were screened for the remaining 4,268 studies, of which 4,239 were excluded due to the extraneous nature of the titles and/or abstracts. Subsequently, 29 full-text articles were assessed, and 19 were removed for lacking the outcome of interest and/or not satisfying the study's inclusion criteria. Finally, 10 studies were included in the review; however, publication bias was not assessed, which is a limitation of this study. In all studies, pharmacists identified a highly significant amount of DRPs through HMR services. The most common types of DRPs were potential drug-drug interactions, serious adverse drug reactions, need for an additional drug, inappropriate medication use, non-adherence, untreated indications, excessive doses, and usage of expired medications.
CONCLUSIONS
HMR is a novel extended role played by pharmacists. The efficiency of such programs in identifying and resolving DRPs could minimize patients' health-related costs and burden, thereby enhancing the quality of life and well-being among the elderly.

Keyword

Pharmacists; Drug-related side effects and adverse reactions; Drug interactions; Aged; Frail elderly

MeSH Terms

Aged*
Drug Interactions
Drug-Related Side Effects and Adverse Reactions
Frail Elderly
Home Care Services
Humans
Pharmacists
Publication Bias
Quality of Life
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