Physician-led medication reviews in polypharmacy patients treated with at least 12 medications in a type 2 diabetes outpatient clinic: A randomised trial
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Physician-led medication reviews in polypharmacy patients treated with at least 12 medications in a type 2 diabetes outpatient clinic : A randomised trial. / Johansson, Karl Sebastian; Kornholt, Jonatan; Bülow, Cille; Petersen, Tonny Studsgaard; Perrild, Hans; Rungby, Jørgen; Christensen, Mikkel Bring.
In: Diabetic Medicine, Vol. 40, No. 4, e15052, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Physician-led medication reviews in polypharmacy patients treated with at least 12 medications in a type 2 diabetes outpatient clinic
T2 - A randomised trial
AU - Johansson, Karl Sebastian
AU - Kornholt, Jonatan
AU - Bülow, Cille
AU - Petersen, Tonny Studsgaard
AU - Perrild, Hans
AU - Rungby, Jørgen
AU - Christensen, Mikkel Bring
N1 - Publisher Copyright: © 2023 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.
PY - 2023
Y1 - 2023
N2 - Aims: Medication reviews can be used to promote appropriate pharmacotherapy and negate the harmful consequences of polypharmacy. This study aimed to evaluate the effect of physician-led medication reviews and increased cross-sectoral communication as a supplement to standard care in a type 2 diabetes outpatient clinic. Methods: This pragmatic randomised clinical trial enrolled patients with type 2 diabetes treated with at least 12 medications. The subjects were randomised to either standard care (standard care consultation at the outpatient clinic) or standard care plus a medication review consultation and increased cross-sectoral communication. The primary outcome was the number of medications used after six months. Health-related quality of life was quantified using the EuroQoL 5-dimension 5-level (EQ5D-5 L) questionnaire. Results: We recruited 50 participants with a median age of 72 (IQR 67–75) years. The mean number of medications per patient changed from 17.9 to 14.3 in the intervention group and 17.6 to 17.2 in the control group (rate ratio 0.81). The reasons for discontinuations were medication no longer indicated (60%), safety issues (20%), efficacy issues (15%) or patient preferences (5%). There was a significant difference in the change in health-related quality of life (EQ5D-5 L index score) in favour of the intervention (0.111, 95% CI 0.001 to 0.221). Conclusions: Physician-led medication reviews and increased cross-sectoral communication in patients with type 2 diabetes treated with at least 12 medications reduced the number of medications used and improved health-related quality of life. Implementing and further investigating similar interventions as standard care seems reasonable.
AB - Aims: Medication reviews can be used to promote appropriate pharmacotherapy and negate the harmful consequences of polypharmacy. This study aimed to evaluate the effect of physician-led medication reviews and increased cross-sectoral communication as a supplement to standard care in a type 2 diabetes outpatient clinic. Methods: This pragmatic randomised clinical trial enrolled patients with type 2 diabetes treated with at least 12 medications. The subjects were randomised to either standard care (standard care consultation at the outpatient clinic) or standard care plus a medication review consultation and increased cross-sectoral communication. The primary outcome was the number of medications used after six months. Health-related quality of life was quantified using the EuroQoL 5-dimension 5-level (EQ5D-5 L) questionnaire. Results: We recruited 50 participants with a median age of 72 (IQR 67–75) years. The mean number of medications per patient changed from 17.9 to 14.3 in the intervention group and 17.6 to 17.2 in the control group (rate ratio 0.81). The reasons for discontinuations were medication no longer indicated (60%), safety issues (20%), efficacy issues (15%) or patient preferences (5%). There was a significant difference in the change in health-related quality of life (EQ5D-5 L index score) in favour of the intervention (0.111, 95% CI 0.001 to 0.221). Conclusions: Physician-led medication reviews and increased cross-sectoral communication in patients with type 2 diabetes treated with at least 12 medications reduced the number of medications used and improved health-related quality of life. Implementing and further investigating similar interventions as standard care seems reasonable.
KW - medication reconciliation
KW - medication review
KW - polypharmacy
KW - type 2 diabetes
U2 - 10.1111/dme.15052
DO - 10.1111/dme.15052
M3 - Journal article
C2 - 36681891
AN - SCOPUS:85147342646
VL - 40
JO - Diabetic Medicine Online
JF - Diabetic Medicine Online
SN - 1464-5491
IS - 4
M1 - e15052
ER -
ID: 365815031