This study investigates if a digital interdisciplinary medicine therapy optimisation (MTO) model in primary care can improve medication therapy, quality of life, medication adherence, and beliefs about medicines, among patients \>65 years living in sparsely populated areas. The intervention includes digital medication interviews, comprehensive medication reviews, interdisciplinary patient-centred discussions, and follow-ups.
Initially, a pilot study will be conducted to evaluate the feasibility of the method and to make appropriate adjustments to the study design before starting the main study. Patients that meet the inclusion criteria will be invited to participate in the study via letter. The patients will also receive three validated questionnaires; Medication Adherence Report Scale-5 (MARS-5), EuroQol-5 Dimension-5 Level questionnaire (EQ-5D-5L) and The Beliefs about Medicines Questionnaire (BMQ) to fill in prior to initiation of the study, to collect baseline data. The intervention consists of several steps and all meetings are digital. At first, the patient will have a medication interview with a clinical pharmacist, Next, the clinical pharmacist conducts a comprehensive medication review based on information from the interview and the participant's medical records and laboratory values. The clinical pharmacist and the participant's primary care physician will then have a joint discussion regarding preliminary medication management proposals and therapy management plans. The patient will be informed by their physician if any medication changes have been made. Digital follow-up meetings with the patient and the clinical pharmacist will take place 1-2, 4 and 12 weeks after the baseline consultation, and additionally if requested by the patient or if the pharmacist consider it necessary. The clinical pharmacist will also conduct repeated medical record reviews every second week during the 12-week intervention period. After the last follow-up at 12 weeks, the patient will be asked to fill in the three questionnaires: MARS-5, EQ-5D-5L and BMQ one more time.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
8
Digital medication interview, comprehensive medication review, interdisciplinary patient-centred discussions, follow-ups
Storuman healthcare centre
Storuman, Sweden
Identification and resolution of drug-related problems
Categorisation of drug-related problems according to a modified version of the Cipolle-Strand-Morley criteria 2012
Time frame: The 12-week intervention period
Change in self-reported medication adherence: Medication Adherence Report Scale-5 (MARS-5)
Assessing self-reported medication adherence through the MARS-5 questionnaire. Total score ranging between 5 and 25, with higher scores indicating a higher level of medication adherence.
Time frame: Baseline and 12 weeks
Change in self-reported health-related quality of life: EuroQol-5 Dimension-5 Level questionnaire (EQ-5D-5L)
Assessing health-related quality of life through the EQ-5D-5L-questionnaire. The questionnaire consists of five questions regarding self-perceived quality of life, and a visual analogue scale on which the respondents evaluate their own health status on a scale of 0-100.
Time frame: Baseline and 12 weeks
Change in self-reported beliefs about medicines: The Beliefs about Medicines Questionnaire (BMQ)
Assessing beliefs about medicines through BMQ. The questionnaire consists of two different scales; BMQ-General assesses the respondent's beliefs about drugs in general and BMQ-Specific evaluates the individual's beliefs about medicines prescribed for their own use.
Time frame: Baseline and 12 weeks
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