Module One_Topic Research Question
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Running head: MODULE ONE_TOPIC RESEARCH QUESTION
1
Topic Research Question Tina Brown
Southern New Hampshire University
HCM 440: Healthcare Research and Evaluation
Professor Qiana Amos, PhD, MPH
January 14, 2024
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The research question that I selected is the following, In older adults (P), how do pharmacists’ medication review interventions (I), as compared to no pharmacists’ medication review interventions (C), affect their prescription use (O)? I used the article, “
Effect of Pharmacist-Led Intervention in Elderly Patients through a Comprehensive Medication Reconciliation: A Randomized Clinical Trial
”, by Lee et al. (2023) to address the topics for this assignment.
The study was a prospective, open-label, randomized clinical trial with patients who were
65 years old and older. The patients included in the study were either part of the intervention group or the control group. The goal of the study was to determine the effectiveness of both a medication review and a comprehensive medication reconciliation intervention by a pharmacist and hospitalist for older patients (Lee et al., 2023). The main outcome of the study concluded that the effect of pharmacist-led interventions using comprehensive medication reconciliation helped to decrease the adverse drug events (ADEs) throughout hospitalization and 30 days after discharge.
The data collection methods used in the study included obtaining patient specific demographics and specific laboratory data for these patients. Additionally, a face-to-face interview was conducted. The interview asked each patient “about [their] swallowing ability, patient-reported adverse events, use of over-the-counter drugs, and complementary and alternative medicines” (Lee et al., 2023). Other patient medical history information was obtained such as dementia, cognitive impairment, gastric ulcer, constipation, and falls or fractures to recognize any potentially inappropriate medications that were not recommended for use as a result of medication and/or disease interactions (Lee et al., 2023). All reported adverse drug
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events (ADE’s) were documented in a database so the pharmacist could review with the patient 30 days after discharge after the physician validated the ADE. A “comprehensive medication reconciliation is a series of clinical pharmacist activities, including medication reconciliation through a face-to-face interview at admission and daily medication review, reducing regimen complexity and daily review of adverse events” (Lee et al.,
2023). A full-time pharmacist was available to the intervention group from Monday-Friday to perform interventions and medication reconciliations. This was not available the control group. Upon admission, the patients in the intervention group received a face-to-face interview with the pharmacist to obtain a list of the patient’s current medications, review any errors with self-
medications, and determine any potentially inappropriate medications (PIM’s), the determination
PIM’s was performed again upon discharge. The primary outcome of the study was the difference in the number of ADEs reported while in the hospital and 30 days after discharge between the intervention and control group. “Of
the 32 patients, 34.4% reported ADEs before discharge, and 19.2% ADEs were reported at the 30 day phone call. No ADEs were reported in the intervention group, whereas five events were reported in the control group” (Lee et al., 2023). Another outcome of the study “were the differences in the change of medication regimen complexity index, the number of PIMs, and the number of drugs between the intervention and control groups (Lee et al., 2023).
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References
Lee, S., Yu, Y. M., Han, E., Park, M. S., Lee, J., & Chang, M. J. (2023). Effect of Pharmacist-
Led Intervention in Elderly Patients through a Comprehensive Medication Reconciliation: A Randomized Clinical Trial.
Yonsei Medical Journal
,
64
(5), 336.
https://doi.org/10.3349/ymj.2022.0620