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Table 2 Summary of study characteristics

From: Deprescribing interventions and their impact on medication adherence in community-dwelling older adults with polypharmacy: a systematic review

Ref

Study design

Setting

Study duration (months)

Total number of participants (N = intervention group where relevant)

Type of intervention/ person leading

Usual care (if applicable)

Adherence outcome

Basheti 2016

Jordan

RCT

Outpatient Clinic

3

112

(N = 50)

Follow up Pharmacist led medication review

Routine clinical practice

Reduction in self- reported non-adherence in intervention group (P < 0.001) compared with control group (P = 0.168)

Beer 2011

Australia

RCT

Home setting and residential aged-care facility

Unknown

30

(N = 15)

Physician led targeted medication withdrawal

Usual care

No significant difference between the groups

P = 0.17

Campins 2017

Spain

RCT

Primary care centres

12

503

(N = 252)

Pharmacist led medication review

Routine clinical practice

At 6 months adherence was higher in the intervention group (76.4% v 64.1%) P = 0.005

Grymonpre

2001 Canada

RCT

Community based clinic

Variable

(from baseline to follow up letter)

135

(N = 69)

Pharmacist led medication review

Routine clinical practice

No significant impact on adherence from baseline to follow-up (P = 0.895)

Haag 2016

USA

RCT

Primary care outpatient clinic

1

25

(N = 13)

Pharmacist led medication review

Pre-existing out-patient care transition programme

No significant difference in adherence P = 0.65

Hanlon 1996

USA

RCT

General Medicine Clinic at Veterans Affairs Medical Centre

12

208

(N = 105)

Pharmacist led medication review

Usual care

No significant difference in medication compliance (P = 0.88)

Hedegaard 2015

Denmark

RCT

Outpatient clinics

12

532

(N = 240)

Pharmacist led medication review

Routine clinical practice

Trend toward improved adherence at 3, 9 and 12 months. Greater % of control group non-adherent compared with intervention group 30.2% vs 20.3% P = 0.01.

Jaeger 2017

Germany

RCT

GP Practices

9

273

(N = 143)

Tailored medication review programme delivered by GPs and Health Care Assistants

Routine clinical practice

No significant effects on adherence P = 0.11

Lowe 2000

UK

RCT

General Practice / Home setting

3

161

(N = 77)

Pharmacist led review

Routine clinical practice

Significant difference in mean compliance score (tablet count and self –reported). Intervention group = 91.3% vs 79.5% control group. P < 0.001

Sturgess 2003

Northern Ireland

RCT

Community Pharmacies

18

191

(N = 110)

Community Pharmacist intervention programme

Routine Practice

Significant increase in compliance and fewer problems with medication compared with control group (P < 0.05)

Vinks 2009

Netherlands

RCT

Community Pharmacy

4

174

(N = 87)

Community Pharmacist review

Usual Practice

Significant reduction in the number of drug related problems per patient (includes non-compliance) -16.3% (−24.3,-8.3) 95% CI

Messerli 2016

Switzerland

RCT

Community Pharmacy

7

450

(N = 218)

Community Pharmacist

Polymedication Check (PMC)

Routine practice

No significant difference in adherence between the two groups could be observed (p = 0.817)

Chen 2016

Taiwan

Prospective cross-sectional

Outpatient clinics

3

152

Pharmacist led medication therapy management service

 

Increase in medication adherence (MMAS-4 scale) from 3.02 to 3.92 (p < 0.001)

Fiss 2013

Germany

Prospective cohort

Ambulatory primary healthcare

1–24

(mean = 9)

911

(N = 393)

Pharmaceutical care from local pharmacy plus medical intervention by GP

 

Increased in adherence forgetfulness P = 0.001

Increased adherence deliberate p = 0.003

(n = 400) between baseline and follow up

Griffiths 2004

Australia

Cohort

Community / Home setting

1

N = 24

Community nurse medication review

Routine clinical practice

No significant difference in non-adherence pre and post intervention

(P = 0.237)

Hatah 2014

New Zealand

Retrospective cohort

Community Pharmacy

6 to 41

N = 353

Community Pharmacist Medicines Use Review (MUR)

 

No significant difference except during the third visit where more patients with lower adherence scores did not return P < 0.001

Lee 2015

Hong Kong

Prospective Uncontrolled

Community outreach

8

N = 103

Pharmacist led review

Routine clinical practice

Significant reduction in Morisky Medication Adherence score P = 0.005

Raynor 2000

UK

Cohort

Community Pharmacy/home setting

2

N = 143

Community Pharmacist led medication adherence support

Routine practice

Non-adherence fell from 38% to 14% (P < 0.001)

Roth 2013

USA

Prospective

Community based primary care medical practice

6

64

Clinical Pharmacist led medication review

Routine clinical practice

Significant reduction in the number of medication related problems per patient (P < 0.001)

which included non- adherence

Steele 2016

USA

Prospective Study

Home based

3

25

Pharmacist conducted home based medication review

Routine practice

Non- adherence was significantly reduced (P = 0.012)

Tan 2014

Australia

Prospective Study

Community clinic/ home setting

6

82

Pharmacist led review

Routine practice

Significant improvement in adherence (44.1% v 62.7% P = 0.023)

Twigg 2015

UK

Service Evaluation

Community Pharmacy

6

620

Community Pharmacist Review

Routine Practice

Significant increase in adherence 0.513 .337 to 0.689) 95% CI