TY - JOUR
T1 - Impact of medication reviews on potentially inappropriate medications and associated costs among older women in aged care
AU - Thiruchelvam, Kaeshaelya
AU - Byles, Julie
AU - Hasan, Syed Shahzad
AU - Egan, Nicholas
AU - Kairuz, Therese
N1 - Funding Information:
This study was conducted as part of the Australian Longitudinal Study on Women's Health by the University of Newcastle and the University of Queensland. We are grateful to the Australian Government Department of Health for funding, as well as to the women who provided the survey data. The authors also acknowledge the Australian Institute of Health and Welfare (AIHW) as the integrating authority, and the Departments of Health and Veterans' Affairs, and Medicare Australia, for providing PBS data.
Funding Information:
In Australia, Residential Medication Management Reviews (RMMRs) are patient-centred medication reviews initiated by general practitioners (GPs) or medical practitioners, and conducted by Accredited Pharmacists; the process involves systematically evaluating the individual's medication regimen and management.22 The RMMR aims to optimise the benefits of medications, improve therapeutic outcomes, and ensure appropriate use of medications.22 The RMMR is a federally-funded service by Medicare, Australia's universal health insurance scheme, and GPs and Accredited Pharmacists are remunerated by the Australian Department of Health and the Pharmacy Programs Administrator.23,24 The Australian Government has allocated AUD$1.20 billion for professional pharmacy programs, including RMMRs, from 2020 until 2025.25The Australian Government Department of Health funds the Australian Longitudinal Study on Women's Health and permit use of Study data for research purposes. The Department has no other role with respect to this research paper.This study was conducted as part of the Australian Longitudinal Study on Women's Health by the University of Newcastle and the University of Queensland. We are grateful to the Australian Government Department of Health for funding, as well as to the women who provided the survey data. The authors also acknowledge the Australian Institute of Health and Welfare (AIHW) as the integrating authority, and the Departments of Health and Veterans' Affairs, and Medicare Australia, for providing PBS data.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: The Residential Medication Management Review (RMMR) service is a large investment by the Australian government and involves considerable time commitment. Objectives: This study determined the impact of RMMRs on the use of potentially inappropriate medications (PIMs), benzodiazepines and antidepressants, described patterns of PIM use, and examined costs. Methods: The study included 5576 participants from the Australian Longitudinal Study on Women's Health from 2005 to 2017. Three generalised estimating equation (GEE) models were specified to separately analyse the impact of RMMRs on the use of PIMs, benzodiazepines and antidepressants. Descriptive statistics were used to present, at each year, the proportions of participants with PIMs, patterns of PIMs and costs of PIMs. Results: There was no evidence for an association between the use of RMMRs and the use of PIMs (OR = 0.99; 95% CI = 0.88, 1.11), benzodiazepines (OR = 1.02; 95% CI = 0.95, 1.08) or antidepressants (OR = 0.99; 95% CI = 0.90, 1.10) in the following year. There were few differences in the use of particular classes of PIMs, nor any differences in the median benefits paid by government or out-of-pocket costs, between participants who did and did not receive RMMRs. There was a slight increase in median OOP costs and a decrease in government benefits over time. Conclusions: There was a lack of long-term changes on use of PIMs, however, its appropriate use must be considered during RMMRs. Healthcare professionals have an obligation to optimise the service to reduce medication costs whilst improving health outcomes among individuals residing in RACF.
AB - Background: The Residential Medication Management Review (RMMR) service is a large investment by the Australian government and involves considerable time commitment. Objectives: This study determined the impact of RMMRs on the use of potentially inappropriate medications (PIMs), benzodiazepines and antidepressants, described patterns of PIM use, and examined costs. Methods: The study included 5576 participants from the Australian Longitudinal Study on Women's Health from 2005 to 2017. Three generalised estimating equation (GEE) models were specified to separately analyse the impact of RMMRs on the use of PIMs, benzodiazepines and antidepressants. Descriptive statistics were used to present, at each year, the proportions of participants with PIMs, patterns of PIMs and costs of PIMs. Results: There was no evidence for an association between the use of RMMRs and the use of PIMs (OR = 0.99; 95% CI = 0.88, 1.11), benzodiazepines (OR = 1.02; 95% CI = 0.95, 1.08) or antidepressants (OR = 0.99; 95% CI = 0.90, 1.10) in the following year. There were few differences in the use of particular classes of PIMs, nor any differences in the median benefits paid by government or out-of-pocket costs, between participants who did and did not receive RMMRs. There was a slight increase in median OOP costs and a decrease in government benefits over time. Conclusions: There was a lack of long-term changes on use of PIMs, however, its appropriate use must be considered during RMMRs. Healthcare professionals have an obligation to optimise the service to reduce medication costs whilst improving health outcomes among individuals residing in RACF.
KW - Aged care
KW - Costs
KW - Medication review
KW - Potentially inappropriate medications
KW - Residential medication management review
UR - http://www.scopus.com/inward/record.url?scp=85130404492&partnerID=8YFLogxK
U2 - 10.1016/j.sapharm.2022.05.003
DO - 10.1016/j.sapharm.2022.05.003
M3 - Article
AN - SCOPUS:85130404492
VL - 18
SP - 3758
EP - 3765
JO - Research in Social and Administrative Pharmacy
JF - Research in Social and Administrative Pharmacy
SN - 1551-7411
IS - 10
ER -