RT Journal Article
SR Electronic
T1 Components of pharmacist-led medication reviews and their relationship to outcomes: a systematic review and narrative synthesis
JF BMJ Quality & Safety
JO BMJ Qual Saf
FD BMJ Publishing Group Ltd
SP bmjqs-2024-017283
DO 10.1136/bmjqs-2024-017283
A1 Craske, Miriam E.
A1 Hardeman, Wendy
A1 Steel, Nicholas
A1 Twigg, Michael J
YR 2024
UL http://qualitysafety.bmj.com/content/early/2024/07/14/bmjqs-2024-017283.abstract
AB Introduction Pharmacist-led medication reviews are an established intervention to support patients prescribed multiple medicines or with complex medication regimes. For this systematic review, a medication review was defined as ‘a consultation between a pharmacist and a patient to review the patient’s total medicines use with a view to improve patient health outcomes and minimise medicines-related problems’. It is not known how varying approaches to medication reviews lead to different outcomes.Aim To explore the common themes associated with positive outcomes from pharmacist-led medication reviews.Method Randomised controlled trials of pharmacist-led medication reviews in adults aged 18 years and over were included. The search terms used in MEDLINE, EMBASE and Web of Science databases were “medication review”, “pharmacist”, “randomised controlled trial” and their synonyms, time filter 2015 to September 2023. Studies published before 2015 were identified from a previous systematic review. Risk of bias was assessed using the Cochrane risk of bias 2 tool. Descriptions of medication reviews’ components, implementation and outcomes were narratively synthesised to draw out common themes. Results are presented in tables.Results Sixty-eight papers describing 50 studies met the inclusion criteria. Common themes that emerged from synthesis include collaborative working which may help reduce medicines-related problems and the number of medicines prescribed; patient involvement in goal setting and action planning which may improve patients’ ability to take medicines as prescribed and help them achieve their treatment goals; additional support and follow-up, which may lead to improved blood pressure, diabetes control, quality of life and a reduction of medicines-related problems.Conclusion This systematic review identified common themes and components, for example, goal setting, action planning, additional support and follow-up, that may influence outcomes of pharmacist-led medication reviews. Researchers, health professionals and commissioners could use these for a comprehensive evaluation of medication review implementation.PROSPERO registration number CRD42020173907.All data relevant to the study are included in the article or uploaded as supplementary information.