Process, impact and outcomes of medication review in Australian residential aged care facilities: A systematic review

Esa Y H Chen; Kate N Wang; Janet K Sluggett; Jenni Ilomäki; Sarah N Hilmer; Megan Corlis; J Simon Bell

doi:10.1111/ajag.12676

Process, impact and outcomes of medication review in Australian residential aged care facilities: A systematic review

Australas J Ageing. 2019 Sep:38 Suppl 2:9-25. doi: 10.1111/ajag.12676.

Authors

Esa Y H Chen^{1

2}, Kate N Wang¹, Janet K Sluggett^{1

2}, Jenni Ilomäki^{1

3}, Sarah N Hilmer^{2

4}, Megan Corlis^{2

5}, J Simon Bell^{1

2

3}

Affiliations

¹ Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.
² NHMRC Cognitive Decline Partnership Centre, University of Sydney, Sydney, New South Wales, Australia.
³ Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.
⁴ Kolling Institute, Faculty of Medicine and Health, The University of Sydney and Royal North Shore Hospital, St Leonards, NSW, Australia.
⁵ Helping Hand Aged Care, North Adelaide, South Australia, Australia.

PMID: 31496065
DOI: 10.1111/ajag.12676

Abstract

Objective: To systematically review literature reporting processes, impact and outcomes of medication review and reconciliation in Australian residential aged care facilities (RACFs).

Methods: PubMed/MEDLINE, EMBASE, CINAHL, Informit Health and grey literature were searched from 1995 to July 2018. Studies reporting outcomes of a stand-alone medication review or reconciliation interventions in Australian RACFs were included.

Results: Thirteen studies investigated medication review, eight of which studied Residential Medication Management Reviews (RMMRs). Five studies reported that medication reviews identified an average of 2.7-3.9 medication-related problems (MRPs) per resident. One study reported medication reviews had no impact on quality of life, hospitalisation or mortality, but was not powered to assess these. Three studies reported general practitioners' acceptance of pharmacists' recommendations to resolve MRPs, ranging between 45 and 84%.

Conclusions: Medication review may be a useful strategy to identify and prompt resolution of MRPs. However, the impact on clinical and resident-centred outcomes remains unclear.

Keywords: aged care; geriatric medicine; health services; medication review; medication therapy management; pharmacist intervention.

Publication types

Systematic Review

MeSH terms

Aged
Aged, 80 and over
Australia
Drug Interactions
Drug-Related Side Effects and Adverse Reactions / prevention & control
Female
Homes for the Aged*
Humans
Inappropriate Prescribing / prevention & control
Male
Medication Errors / prevention & control
Medication Therapy Management*
Nursing Homes*
Outcome and Process Assessment, Health Care*
Polypharmacy
Risk Assessment
Risk Factors