Pharmacists' and older adults' perspectives on the benefits and barriers of Home Medicines Reviews – a qualitative study. Issue 2 (April 2020)

• Record Type: Journal Article
• Authors: Weir, Kristie Rebecca; Naganathan, Vasi; Bonner, Carissa; McCaffery, Kirsten; Rigby, Debbie; McLachlan, Andrew J; Jansen, Jesse
• Is Part Of: Journal of health services research & policy. Volume 25:Issue 2(2020)
• Page Start: 77
• Page End: 85
• Publication Date: 2020-04
• Subjects: Home medicines reviews -- older patients -- polypharmacy; Medical care -- Periodicals; Medical policy -- Periodicals; Public health -- Periodicals; 362.105
• DOI: 10.1177/1355819619858632
• Languages: English
• ISSNs: 1355-8196

Abstract

Objectives: Conducting a medication review is one way to optimize medications and support older people to reduce the burden of polypharmacy. In Australia, a service called a Home Medicines Review (HMR) is conducted by pharmacists as part of a nationally funded program. HMRs aim to identify and resolve problems associated with polypharmacy and improve collaboration between patient, pharmacist and general practitioner. The aim of this study was to explore the benefits of and barriers to HMRs from the perspective of older patients and pharmacists. Methods: This qualitative study involved observations of HMRs ( n = 12) and telephone interviews with 32 participants including 11 accredited pharmacists, 17 older adults aged 65 years and above, with 4 of their companions, in Australia. The researcher observing took notes during the HMR and added more detail and reflections afterwards. Transcribed audio-recordings and observational notes were thematically coded using framework analysis. Results: Older patients and their companions found the HMR useful and they appreciated the opportunity to learn more about their medicines. However, many did not understand the purpose of the HMR, had limited understanding about their medicines and some did not want to know more. Pharmacists found HMRs useful for identifying medication errors and improving adherence. They also reported barriers to effective HMRs relating to patients (resistance to the evaluation of their medicines, misunderstanding about the aim of the HMR) and GPs (limited information upon referral, and limited follow-up afterwards). Conclusions: Older patients and pharmacists reported a range of benefits for HMRs in terms of optimizing medicines use. Barriers to effective HMR use need to be addressed, including gaps in inter-professional communication and factors related to patient involvement, such as limited medicines understanding and health literacy.