Abstract
This review and meta-analysis aimed to determine the clinical and humanistic outcomes of community pharmacy-based interventions on medication-related problems of older adults at the primary care level. We identified randomized controlled trials (RCTs) examining the impact of various community pharmacy-based interventions from five electronic databases (namely, MEDLINE (Ovid), EMBASE (Ovid), CINAHL, APA PSYInfo, and Scopus) from January 2010 to December 2020. Consequently, we assessed these interventions’ clinical and humanistic outcomes on older adults and compared them with non-intervention. We included 13 RCTs in the current review and completed a meta-analysis with six of them. The included studies had a total of 6173 older adults. Quantitative analysis showed that patient education was significantly associated with an increase in the discontinuation of sedative–hypnotics use (risk ratio 1.28; 95% CI (1.20, 1.36) I2 = 0%, p < 0.00001). Moreover, the qualitative analysis showed that medication reviews and education with follow-ups could improve various clinical outcomes, including reducing adverse drug events, reducing uncontrolled health outcomes, and improving appropriate medication use among the elderly population. However, medication review could not significantly reduce the number of older adults who fall (risk ratio 1.25; 95% CI (0.78, 1.99) I2 = 0%, p = 0.36) and require hospitalization (risk ratio 0.72; 95% CI (0.47, 1.12) I2 = 45%, p = 0.15). This study showed that community pharmacy-based interventions could help discontinue inappropriate prescription medications among older adults and could improve several clinical and humanistic outcomes. However, more effective community pharmacy-based interventions should be implemented, and more research is needed to provide further evidence for clinical and humanistic outcomes of such interventions on older adults.
Highlights
There is an ever-increasing need for healthcare services for older adults because of the increase in the aging population
The current review showed that patient education delivered by community pharmacists increased the number of older adults who benefited from the pharmacists’ interventions and discontinued their sedative–hypnotic drugs
The current review showed that there are several healthcare interventions conducted by community pharmacists for the elderly population
Summary
There is an ever-increasing need for healthcare services for older adults because of the increase in the aging population. Medication-use problems of older adults are complex and multifaceted and cause an enormous public health, social, and financial burden to the economy [6,7]. The problems related to medication usage in older adults happen at both secondary/tertiary and primary care levels. The involvement of multiple healthcare professionals, via a collaborative care model, and the focus on medication safety can help identify and minimize medication-related problems of older adults. The primary care level lacks a geriatric-focused care delivery that can identify complex healthcare and medication usage need of older adults and support them adequately
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