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Intervention delivery within the MedBridge trial: final assessment of comprehensive medication reviews
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
2019 (English)Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

Background: The Medication Reviews Bridging Healthcare (MedBridge) study is a multicentre, cluster-randomised trial aiming to study the effects of hospital-initiated comprehensive medication reviews (CMRs), with and without active follow-up, on elderly patients’ healthcare utilisation. In order to draw solid conclusions from the outcomes within MedBridge, it is important to investigate the quality by which the interventions have been delivered throughout the trial.

Aim: To investigate and compare the intervention delivery at all wards within all MedBridge study periods, as a part of the process evaluation within the MedBridge study.

Methods and materials: One-third of the patients from all intervention periods in all wards at the hospitals in Uppsala, Enköping, Gävle and Västerås were randomised to this sub-study. Discrepancies, DRPs and pharmacist proposals were identified and categorised by screening the patients’ medical records. Correction rates of discrepancies and acceptance rates of proposals were calculated. Tukey-kramer test was used to compare numerical variables and chi-square test was used to compare categorical variables between wards.

Results: A total of 581 patients (53 % women) with a mean age of 81 years were included. A mean number of 1.1 discrepancies and 2.0 DRPs were found within all wards together. Between-ward comparison showed a difference in terms of numbers of DRPs (p < 0.01). Overall discrepancy correction rate was 77 % and the proposal acceptance rate was 63 % for all wards together, with differences between wards (p < 0.01 and p < 0.01 respectively).

Conclusion: Overall, the interventions in the MedBridge study have been well- delivered. The intervention delivery is similar in terms of number of identified discrepancies but the correction rate of discrepancies, number of identified DRPs and acceptance rate of pharmacist proposals differ between the wards. The clinical relevance of these differences is unknown.

Place, publisher, year, edition, pages
2019. , p. 39
Keywords [en]
Comprehensive medication reviews, Discrepancy, Drug-related problems, MedBridge
Keywords [sv]
Fördjupade läkemedelsgenomgång, Avvikelse i läkemedelslista, Läkemedelsrelaterade problem, MedBridge
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-376864OAI: oai:DiVA.org:uu-376864DiVA, id: diva2:1287666
External cooperation
Uppsala University Hospital
Subject / course
Pharmacotherapy
Educational program
Master Programme in Drug Management
Supervisors
Examiners
Available from: 2019-02-12 Created: 2019-02-11 Last updated: 2019-02-12Bibliographically approved

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CiteExportLink to record
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