Factors affecting the delivery of community pharmacist-led medication reviews: evidence from the MedsCheck annual service in OntarioReport as inadecuate




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BMC Health Services Research

, 16:666

Utilization, expenditure, economics and financing systems

Abstract

BackgroundMedication reviews have become part of pharmacy practice across developed countries. This study aimed to identify factors affecting the likelihood of eligible Ontario seniors receiving a pharmacy-led medication review called MedsCheck annual MCA.

MethodsWe designed a cohort study using a random sample of pharmacy claims for MCA-eligible Ontario seniors using linked administrative data from April 2012 to March 2013. Guided by a conceptual framework, we constructed a generalized-estimating-equations model to estimate the effect of patient, pharmacy and community factors on the likelihood of receiving MCA.

ResultsOf the 2,878,958 eligible claim-dates, 65,605 included an MCA. Compared to eligible individuals who did not receive an MCA, recipients were more likely to have a prior MCA OR = 3.03, receive a new medication on the claim-date OR = 1.78, be hypertensive OR = 1.18 or have a recent hospitalization OR = 1.07. MCA recipients had fewer medications e.g., OR = 0.44 for ≥12 medications versus 0–4 medications, and were less likely to receive an MCA in a rural OR = 0.74 or high-volume pharmacy OR = 0.65.

ConclusionsThe most important determinant of receiving an MCA was having had a prior MCA. Overall, MCA recipients were healthier, younger, urban-dwelling, and taking fewer medications than non-recipients. Policies regarding current and future medication review programs may need to evolve to ensure that those at greatest need receive timely and comprehensive medication reviews.

KeywordsMedication review Pharmacy Predictors Community Elderly AbbreviationsADGAggregated Diagnosis Groups

CANCanadian

CMRComprehensive medication review

DINDrug identification numbers

EDEmergency Department

GEEGeneralized Estimating Equations

HFHeart failure

ICESInstitute for Clinical Evaluative Sciences

LTCLong-term Care

MCMedscheck

MCAMedsCheck annual

MOHLTCOntario Ministry of health and Long-term Care

MTMMedication therapy management

MURMedicines Use Reviews

ODBOntario Drug Benefit

OPENOntario Pharmacy Research Collaboration

OROdds Ratio

QICQuasi-likelihood under the independence model criterion

RIORurality Index of Ontario

SDSSupplemental Digital Content

SESSocio-economic status

UKUnited Kingdom

USUnited States

USAUnited States of America

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Author: Petros Pechlivanoglou - Lusine Abrahamyan - Linda MacKeigan - Giulia P. Consiglio - Lisa Dolovich - Ping Li - Suzanne M. 

Source: https://link.springer.com/







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