Medication Therapy Management Clinical Trial
Official title:
Home Medication Review Services for Non-homebound Community Pharmacy Patients: Evaluation of Medication Management Issues in Non-homebound Patients and Characterization of Ideal Target Population for Home-based Medication Reviews.
RATIONALE:
Several examples in the literature describe the types of medication management issues
uncovered during the course of home-based medication reviews. For example, the investigators
previously reported the outcomes of home medication reviews of 43 homebound community
pharmacy patients, finding that 58% of patients were keeping medications in the home that
were expired, duplicates of other current medications, or no longer therapeutically
appropriate.
Many of these issues, due to their nature, could be considered to be "hidden", i.e. issues
that are unlikely to be adequately detected or resolved during the course of routine
interactions between patients and pharmacists in the community pharmacy setting. Currently,
only homebound patients in Ontario are eligible to receive government-funded home medication
review services from pharmacists. This limitation in funding eligibility is problematic as
it reduces the likelihood that non-homebound patients will receive home medication reviews,
even though this population may also benefit from these services. Indeed, evidence in the
literature is not limited exclusively to homebound patients, and suggests that non-homebound
patients are also at risk from home-centered medication management issues and may also
benefit from home medication reviews.
PURPOSE:
Our study aims to characterize the prevalence and nature of "hidden in the home" medication
management issues in non-homebound patients. To our knowledge, this study would be the first
of its kind to focus specifically on this patient population and lend direct evidence in
support of expanding funding of home medication review services in Ontario to include
non-homebound patients.
HYPOTHESIS:
A subset of ambulatory, non-homebound patients who regularly attend community pharmacies are
affected by medication management issues that cannot be adequately identified and resolved
during the course of a typical medication review taking place within the pharmacy. These
patients would benefit from a full medication review taking place in their own homes,
similar to what is presently provided under Ontario's MedsCheck at Home program, for which
only homebound patients in Ontario are eligible.
RESEARCH QUESTIONS/OBJECTIVES:
1. What is the frequency of, and what type(s) and severity of, drug-related problems are
detected during pharmacist visits to patients' homes who would not otherwise qualify
for a MedsCheck at Home service?
2. Based on the findings from this study, which criteria would best assist community
pharmacists in identifying ambulatory patients who may stand to benefit most from a
home-based medication review?
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