A systematic review of pharmacist-led medicines review services in New Zealand – is there equity for Māori older adults?

Joanna Hikaka*, Carmel Hughes, Rhys Jones, Martin J. Connolly, Nataly Martini

*Corresponding author for this work

Research output: Contribution to journalReview article

Abstract

Background: Pharmacist involvement in medicines reviews for older adults can improve prescribing and reduce adverse drug reactions. Māori experience poorer health outcomes than non-Māori resulting, in part, from inequitable access to and quality of medicine-related care. Despite international data showing benefit, it is unclear whether pharmacist-led medicines review services can improve outcomes for Māori older adults. Objective: This systematic review aims to describe pharmacist-led medicines review services for community-dwelling adults in New Zealand, assess effectiveness of these interventions and identify their effect on health equity for Māori and older adults. Methods: The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Equity (PRISMA-E 2012). Observational studies were included. The intervention in included studies had to involve a pharmacist, occur in the outpatient setting in New Zealand, and involve review of all medicines for an individual patient. At least one patient-related outcome had to be reported. Results: The search identified seven observational studies with 542 total participants. Study interventions included adherence-based reviews in community pharmacies and multi-step comprehensive clinical reviews in outpatient haemodialysis units. Medicines reviews identified up to a median of 3 drug-related problems per review. The effect of interventions on medicines adherence and knowledge was not clear. Māori may have been less likely than non-Māori to benefit from improved medicines knowledge as a result of interventions. None of the studies incorporated aspects in study design or delivery to address inequities for Māori. Conclusion: Further investigation is needed to understand whether the development of culturally safe pharmacist-led medicines review services, responsive to community identified needs, can help to achieve equity in health outcomes for Māori older adults.

Original languageEnglish
Number of pages12
JournalResearch in Social and Administrative Pharmacy
Early online date14 Jan 2019
DOIs
Publication statusEarly online date - 14 Jan 2019

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Morus
New Zealand
Pharmacists
Medicine
Lead
Observational Studies
Outpatients
Independent Living
Pharmacies
Health
Drug-Related Side Effects and Adverse Reactions
Renal Dialysis
Meta-Analysis
Pharmaceutical Preparations

Keywords

  • Equity
  • Indigenous health
  • Medicines review
  • Māori
  • Older adult
  • Pharmacist

Cite this

@article{3727a73303504894afa7fea3ff2ccb28,
title = "A systematic review of pharmacist-led medicines review services in New Zealand – is there equity for Māori older adults?",
abstract = "Background: Pharmacist involvement in medicines reviews for older adults can improve prescribing and reduce adverse drug reactions. Māori experience poorer health outcomes than non-Māori resulting, in part, from inequitable access to and quality of medicine-related care. Despite international data showing benefit, it is unclear whether pharmacist-led medicines review services can improve outcomes for Māori older adults. Objective: This systematic review aims to describe pharmacist-led medicines review services for community-dwelling adults in New Zealand, assess effectiveness of these interventions and identify their effect on health equity for Māori and older adults. Methods: The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Equity (PRISMA-E 2012). Observational studies were included. The intervention in included studies had to involve a pharmacist, occur in the outpatient setting in New Zealand, and involve review of all medicines for an individual patient. At least one patient-related outcome had to be reported. Results: The search identified seven observational studies with 542 total participants. Study interventions included adherence-based reviews in community pharmacies and multi-step comprehensive clinical reviews in outpatient haemodialysis units. Medicines reviews identified up to a median of 3 drug-related problems per review. The effect of interventions on medicines adherence and knowledge was not clear. Māori may have been less likely than non-Māori to benefit from improved medicines knowledge as a result of interventions. None of the studies incorporated aspects in study design or delivery to address inequities for Māori. Conclusion: Further investigation is needed to understand whether the development of culturally safe pharmacist-led medicines review services, responsive to community identified needs, can help to achieve equity in health outcomes for Māori older adults.",
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A systematic review of pharmacist-led medicines review services in New Zealand – is there equity for Māori older adults? / Hikaka, Joanna; Hughes, Carmel; Jones, Rhys; Connolly, Martin J.; Martini, Nataly.

In: Research in Social and Administrative Pharmacy, 14.01.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - A systematic review of pharmacist-led medicines review services in New Zealand – is there equity for Māori older adults?

AU - Hikaka, Joanna

AU - Hughes, Carmel

AU - Jones, Rhys

AU - Connolly, Martin J.

AU - Martini, Nataly

PY - 2019/1/14

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N2 - Background: Pharmacist involvement in medicines reviews for older adults can improve prescribing and reduce adverse drug reactions. Māori experience poorer health outcomes than non-Māori resulting, in part, from inequitable access to and quality of medicine-related care. Despite international data showing benefit, it is unclear whether pharmacist-led medicines review services can improve outcomes for Māori older adults. Objective: This systematic review aims to describe pharmacist-led medicines review services for community-dwelling adults in New Zealand, assess effectiveness of these interventions and identify their effect on health equity for Māori and older adults. Methods: The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Equity (PRISMA-E 2012). Observational studies were included. The intervention in included studies had to involve a pharmacist, occur in the outpatient setting in New Zealand, and involve review of all medicines for an individual patient. At least one patient-related outcome had to be reported. Results: The search identified seven observational studies with 542 total participants. Study interventions included adherence-based reviews in community pharmacies and multi-step comprehensive clinical reviews in outpatient haemodialysis units. Medicines reviews identified up to a median of 3 drug-related problems per review. The effect of interventions on medicines adherence and knowledge was not clear. Māori may have been less likely than non-Māori to benefit from improved medicines knowledge as a result of interventions. None of the studies incorporated aspects in study design or delivery to address inequities for Māori. Conclusion: Further investigation is needed to understand whether the development of culturally safe pharmacist-led medicines review services, responsive to community identified needs, can help to achieve equity in health outcomes for Māori older adults.

AB - Background: Pharmacist involvement in medicines reviews for older adults can improve prescribing and reduce adverse drug reactions. Māori experience poorer health outcomes than non-Māori resulting, in part, from inequitable access to and quality of medicine-related care. Despite international data showing benefit, it is unclear whether pharmacist-led medicines review services can improve outcomes for Māori older adults. Objective: This systematic review aims to describe pharmacist-led medicines review services for community-dwelling adults in New Zealand, assess effectiveness of these interventions and identify their effect on health equity for Māori and older adults. Methods: The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Equity (PRISMA-E 2012). Observational studies were included. The intervention in included studies had to involve a pharmacist, occur in the outpatient setting in New Zealand, and involve review of all medicines for an individual patient. At least one patient-related outcome had to be reported. Results: The search identified seven observational studies with 542 total participants. Study interventions included adherence-based reviews in community pharmacies and multi-step comprehensive clinical reviews in outpatient haemodialysis units. Medicines reviews identified up to a median of 3 drug-related problems per review. The effect of interventions on medicines adherence and knowledge was not clear. Māori may have been less likely than non-Māori to benefit from improved medicines knowledge as a result of interventions. None of the studies incorporated aspects in study design or delivery to address inequities for Māori. Conclusion: Further investigation is needed to understand whether the development of culturally safe pharmacist-led medicines review services, responsive to community identified needs, can help to achieve equity in health outcomes for Māori older adults.

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KW - Indigenous health

KW - Medicines review

KW - Māori

KW - Older adult

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