What Do Older Adults and Their Caregivers in Malaysia Think of Home Medication Review? A Qualitative Inquiry
Main Article Content
Abstract
Introduction: Home medication review (HMR) involves a patient-centered approach, extending continuity of care to the community setting with the intention of improving medication use and health outcome. The delivery of HMR services in Malaysia remains limited to urban hospitals and clinics. Current study aimed to explore the perception and acceptability of HMR in older adults. Methods: In-depth individual interviews were conducted among adults aged ≥65 years old, taking ≥5 medications, recruited from geriatrics clinics at a tertiary teaching hospital. Home interviews were conducted among 12 older adults and care givers between April to June 2019. Interviews were audio-taped, transcribed verbatim and analysed through descriptive interpretive approach of qualitative data analysis. Results: HMR provided participants with opportunities to discuss medication-related issues with pharmacists in conducive environments. Pharmacists provided information which improved knowledge on indications, dosages and safe storage of medications through HMR. Participants experienced relief and developed confidence in medication self-management. Conclusion: The importance of follow-up visits to ensure adequate monitoring and continuity of care were emphasized. Larger quantitative studies are required to determine the clinical impact and cost-effectiveness of HMR to justify the implementation and expansion of this service.
Downloads
Article Details
References
Ahn J, Park JE, Anthony C, Burke M. Understanding, benefits and difficulties of home medicines review-patients’ perspectives. Aust Fam Physician. 2015;44(4):249-253.
Medicare Benefit Schedule. The Australian Government Department of Health and Ageing [Internet]. 2012. [cited 2020 November 02]. Available from: http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/276B8A3E93673BECCA257CCF00051C25/$File/201212-Allied.pdf.
White L, Klinner C, Carter S. Consumer perspectives of the Australian Home Medicines Review Program: benefits and barriers. Res Social Adm Pharm. 2012;8(1):4-16.
Gudi SK, Kashyap A, Chhabra M, Rashid M, Tiwari KK. Impact of pharmacist-led home medicines review services on drug-related problems among the elderly population: a systematic review. Epidemiology and Health. 2019;41.
Huynh K, Erny-Albrecht K, McIntyre E. Home Medicine Reviews: Recent changes and potential implications. 2014.
Flanagan PS, Barns A. Current perspectives on pharmacist home visits: do we keep reinventing the wheel? Integrated pharmacy research & practice. 2018;7:141-159.
Morin L, Johnell K, Laroche M-L, Fastbom J, Wastesson JW. The epidemiology of polypharmacy in older adults: register-based prospective cohort study. Clin Epidemiol. 2018;10:289-298.
Davies E, O’mahony M. Adverse drug reactions in special populations–the elderly. Br J Clin Pharmacol. 2015;80(4):796-807.
Wauters M, Elseviers M, Vaes B, Degryse J, Dalleur O, Vander Stichele R, et al. Too many, too few, or too unsafe? Impact of inappropriate prescribing on mortality, and hospitalization in a cohort of community-dwelling oldest old. Br J Clin Pharmacol. 2016;82(5):1382-1392.
Blenkinsopp A, Bond C, Raynor DK. Medication reviews. Br J Clin Pharmacol. 2012;74(4):573-580.
Sellappans R, Prakash A, Sundus A. 155 Polypharmacy Burden: How to Optimise, a Practical Approach. Age Ageing. 2019;48(4):34-39.
MOH HMR Protocol. Home Medication Review Protocol [Internet]. 2011. [cited 2020 November 02]. Available from: https://www.pharmacy.gov.my/v2/en/documents/home-medication-review-protocol.html.
MOH Malaysia. Home care pharmacy services protocol [Internet]. Pharmaceutical Services Program, Ministry of Health Malaysia.; 2019. [cited 2020 November 02]. Available from: https://www.pharmacy.gov.my/v2/sites/default/files/document-upload/home-care-pharmacy-services-protocol-2nd-edition-2019.pdf.
Burnard, P., Gill, P., Stewart, K., Treasure, E., & Chadwick, B. (2008). Analysing and presenting qualitative data. British Dental Journal, 204(8), 429-432.
Dhillon AK, Hattingh HL, Stafford A, Hoti K. General practitioners’ perceptions on home medicines reviews: a qualitative analysis. BMC Fam Pract. 2015;16(1):1-6.
Campbell Research Consulting. Home medicines review program qualitative research project final report.: Department of Health and Aging. Medicare Australia.; 2008.
Young UK. Evaluation of the home medicines review program-pharmacy component [Internet]. 2005. [cited 2020 November 02]. Available from: http://6cpa.com.au/resources/third-agreement/evaluation-of-hmr-program/.
Jokanovic N, Tan EC, van den Bosch D, Kirkpatrick CM, Dooley MJ, Bell JS. Clinical medication review in Australia: a systematic review. Research in Social and Administrative Pharmacy. 2016;12(3):384-418.
Doval HC, Borracci RA, Darú VD, Giorgi MA, Samarelli M. Perception of consultation length in cardiology and its ethical implications. Rev Panam Salud Publica. 2008;24:31-35.
Carlsen KH, Carlsen KM, Serup J. Non-attendance, predictors and interventions. Adherence in Dermatology: Springer; 2016. p. 29-35.
Gold PE, Korol DL. Forgetfulness during aging: An integrated biology. Neurobiol Learn Mem. 2014;112:130-138.
Shao J, Zhang Q, Ren Y, Li X, Lin T. Why are older adults victims of fraud? Current knowledge and prospects regarding older adults’ vulnerability to fraud. Journal of elder abuse & neglect. 2019;31(3):225-243.
Quek D, editor The Malaysian healthcare system: a review. Intensive workshop on health systems in transition: 29-30 April 2009; Kuala Lumpur; 2009: University of Malaya.
Tobi SM, Fathi M, Amaratunga D, editors. Ageing in place, an overview for the elderly in Malaysia. AIP conference proceedings; 2017: AIP Publishing LLC.