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1. Impact of physician’ and pharmacy staff supporting activities in usual care on patients’ statin adherence

Author

Victor Johan Bernard Huiskes, Johanna Everdina Vriezekolk, Cornelia Helena Maria van den Ende, Liset van Dijk, and Bartholomeus Johannes Fredericus van den Bemt

Subjects
Medicine, Science
Abstract

Aims Little is known about usual care by physicians and pharmacy teams to support adherence to statins and whether the extent of this care is associated with adherence to statins. Objective of the study was to examine the relationship between the extent of adherence supporting activities of healthcare practitioners (HCPs) and patients’ adherence to statins. Methods Cross-sectional study in 48 pharmacies and affiliated physicians’ practices, between September 3, 2014 and March 20, 2015. Patients visiting the pharmacy with a statin prescription from participating prescribers were invited to participate. Usual care to support adherence was assessed among HCPs with the Quality of Standard Care questionnaire about usual care activities to support adherence. Adherence to statins was assessed among patients with the MARS-5 questionnaire. The association between the extent of HCPs’ adherence supporting activities and patients’ adherence was examined by means of multilevel regression analysis. Results 1,504 patients and 692 HCPs (209 physicians, 118 pharmacists and 365 pharmacy technicians) participated. No association was found between the extent of physicians’ adherence supporting activities and patients’ adherence to statins. The extent of adherence supporting activities by pharmacy teams in usual care was negatively associated with patients’ adherence to statins (B coefficient -0.057 (95%CI: -0.112- -0.002). Conclusions This study suggests that there is no positive relationship between the extent of HCPs’ adherence supporting activities in usual care and patients’ adherence to statins. Other methods than questionnaires (e.g. electronic monitors (to assess adherence) and observations (to assess usual care) should be applied to confirm the results of this study.

Published
2022

2. Association between healthcare practitioners' beliefs about statins and patients' beliefs and adherence

Author

Liset van Dijk, Bartholomeus Johannes Fredericus van den Bemt, Cornelia H. M. van den Ende, Victor J. B. Huiskes, David M. Burger, RS: Carim - V01 Vascular complications of diabetes and metabolic syndrome, Clinical Pharmacy, PharmacoTherapy, -Epidemiology and -Economics, and Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)

Subjects
Male, pharmacy, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, education, Pharmacy, Primary care, Pharmacists, 030226 pharmacology & pharmacy, LONG-TERM PERSISTENCE, law.invention, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], statins, 03 medical and health sciences, primary care, 0302 clinical medicine, law, Surveys and Questionnaires, Health care, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, adherence, Association (psychology), Aged, Pharmacology, general practice, RISK, ischemic-heart-disease, therapy, Clinical pharmacology, business.industry, Mean age, Multilevel regression, Cross-Sectional Studies, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], PERSPECTIVES, Family medicine, cardiology, MEDICINES, General practice, medication adherence, Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5], Female, clinical pharmacology, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business
Abstract

Contains fulltext : 232373.pdf (Publisher’s version ) (Closed access) AIMS: Adherence to statins ranges from 32% to 79%. Patients' beliefs about medication are associated with adherence. There is lack of insight into the possible association between beliefs of healthcare practitioners (HCPs) about statins and patients' beliefs and adherence. This study aims to examine whether HCPs' beliefs about statins are associated with patients' beliefs and adherence about/to statins. METHODS: Cross-sectional study in 48 pharmacies and affiliated physicians' practices between 3 September 2014 and 20 March 2015. HCPs' (prescribers and pharmacy staff) and patients' beliefs about statins were assessed with the Beliefs about Medicine Questionnaire (BMQ) specific. Adherence to statins was assessed with the MARS-5 questionnaire. Multilevel regression analysis was performed to assess the association between HCPs' beliefs and patients' beliefs and adherence. RESULTS: 1504 patients (mean age 66.8 [s.d. ± 9.9] years, 46.5% female) and 734 HCPs (209 physicians, 118 pharmacists and 366 pharmacy technicians) participated in this study. Patients have higher BMQ necessity (16.9 [s.d. ± 4.3]) and BMQ concern (12.3 [s.d. ± 3.9]) scores than HCPs (15.0 [s.d. ± 3.0] and 11.5 [s.d. ± 2.9], P < 0.001). No associations were found between any of the HCPs' BMQ and patients' BMQ scores and adherence to statins. Patients' BMQ necessity, concern and necessity-concerns (NC)-differential scores were associated with patients' adherence (MARS-5) scores. B (95% CI) coefficients were 0.057 (0.035-0.079), -0.040 (-0.064 to -0.016) and.061 (0.043-0.079). CONCLUSIONS: Patients have stronger beliefs about medication compared to HCPs. No associations were found between HCPs' BMQ scores on the one hand and patients' BMQ scores and adherence to statins on the other hand.

Published
2021
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3. Effectiveness of medication review on the number of drug-related problems in patients visiting the outpatient cardiology clinic: A randomized controlled trial

Author

David M. Burger, Bartholomeus Johannes Fredericus van den Bemt, Victor J. B. Huiskes, Martine Kruijtbosch, Veronique Maria Mathea Meijs, Marieke Meijs, Cornelia H. M. van den Ende, Hendrik Tinus Ensing, RS: Carim - V01 Vascular complications of diabetes and metabolic syndrome, and Clinical Pharmacy

Subjects
Male, drug safety, pharmacist, SCREENING TOOL, Pharmacists, 030226 pharmacology & pharmacy, law.invention, admissions, 0302 clinical medicine, Randomized controlled trial, law, Outpatients, Pharmacology (medical), 030212 general & internal medicine, media_common, Medication review, OUTCOMES, Clinical pharmacology, primary-care, prescribing, alert doctors, Pharmaceutical Preparations, Female, drug utilization, Drug, Adult, medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, media_common.quotation_subject, Pharmacist, Cardiology, elderly-patients, ward, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, medicine, Humans, In patient, Aged, Pharmacology, business.industry, Telephone call, Original Articles, drug development, quality use of medicines, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Emergency medicine, Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5], clinical pharmacology, Quality use of medicines, business, randomised controlled trial
Abstract

Contains fulltext : 218099.pdf (Publisher’s version ) (Closed access) AIMS: To assess the effectiveness of medication review on the number of drug-related problems (DRPs) in outpatient cardiology patients. METHODS: In this randomized controlled trial, a computer-assisted and pharmacist-led medication review with patient involvement (questionnaire and telephone call with pharmacist) was conducted in intervention patients prior to their visit to the cardiologist. The control group received usual care. Adult outpatient cardiology patients without support concerning the administration of medication, without a medication review in the past 6 months and who gave permission to access their electronic medication record were included. The primary outcome measure was the number of DRPs 1 month after the visit. Secondary outcome measures concerned the type of DRP and the type of medication involved in the DRPs. RESULTS: In total, 75 patients (mean [standard deviation, SD] age 66.0 [12.5] years, 41% female) were included. Intervention (n = 90) and control group (n = 85) were comparable at baseline. The mean (SD) number of drugs used per patient was 7.9 (3.9). After 1 month, the mean (SD) number of DRPs was 0.3 (0.7) and 0.8 (1.0) and the median (range) number of DRPs was 0 (0-4) and 0 (0-4) in the intervention group and control group, respectively (P < .001). In the intervention group, 74% of the DRPs identified at T0 were solved at T1 vs 14% in the control group. CONCLUSION: This randomized controlled trial suggests that a pharmacist-led medication review in patients with a scheduled visit to the outpatient cardiology clinic decreases the number of DRPs.

Published
2020

4. Effectiveness of medication review

Author

Bartholomeus Johannes Fredericus van den Bemt, Victor J. B. Huiskes, Cornelia H. M. van den Ende, David M. Burger, MUMC+: DA KFT Medische Staf (9), and RS: FHML non-thematic output

Subjects
Male, Pediatrics, Psychological intervention, 030226 pharmacology & pharmacy, law.invention, 0302 clinical medicine, Quality of life, Randomized controlled trial, law, Clinical outcomes, Drug-related outcomes, 030212 general & internal medicine, ELDERLY-PATIENTS, Randomized Controlled Trials as Topic, Evidence-Based Medicine, NURSING-HOME RESIDENTS, Health Care Costs, Economical outcomes, Treatment Outcome, Systematic review, Pharmaceutical Preparations, Meta-analysis, HOSPITAL ADMISSIONS, Female, Family Practice, Research Article, Medication review, Meta-analysis[Publication Type], medicine.medical_specialty, Medication Therapy Management, MEDLINE, Drug Costs, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, PHARMACOTHERAPY CONSULTATION, Drug utilization review[Mesh], medicine, Review[Publication Type], Humans, CARE PATIENTS, OLDER-PEOPLE, CLINICAL PHARMACIST, Polypharmacy, Pharmaceutical services[Mesh], business.industry, ADVERSE DRUG-REACTIONS, POTENTIALLY INAPPROPRIATE MEDICATION, Drug Utilization, United States, Clinical pharmacy, THERAPY MANAGEMENT, lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4], Pharmaceutical Services, Emergency medicine, Inflammatory diseases Radboud Institute for Health Sciences [Radboudumc 5], business
Abstract

Background Medication review is often recommended to optimize medication use. In clinical practice it is mostly operationalized as an intervention without co-interventions during a short term intervention period. However, most systematic reviews also included co-interventions and prolonged medication optimization interventions. Furthermore, most systematic reviews focused on specific patient groups (e.g. polypharmacy, elderly, hospitalized) and/or on specific outcome measures (e.g. hospital admissions and mortality). Therefore, the objective of this study is to assess the effectiveness of medication review as an isolated short-term intervention, irrespective of the patient population and the outcome measures used. Methods A literature search was performed in MEDLINE, EMBASE and Web of Science from their inception through September 2015. Randomized controlled trials (RCTs) with medication review as isolated short term intervention (

Published
2017
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