| アブストラクト | BACKGROUND: Medication reviews in primary care provide an opportunity to review and discuss the safety and appropriateness of a person's medicines. However, there is limited evidence about access to and the impact of routine medication reviews for older adults in the general population, particularly in the UK. We aimed to quantify the proportion of people aged 65 years and over with a medication review recorded in 2019 and describe changes in the numbers and types of medicines prescribed following a review. METHODS: We used anonymised primary care electronic health records from the UK's Clinical Practice Research Datalink (CPRD GOLD) to define a population of people aged 65 years or over in 2019. We counted people with a medication review record in 2019 and used Cox regression to estimate associations between demographic characteristics, diagnoses, and prescribed medicines and having a medication review. We used linear regression to compare the number of medicines prescribed as repeat prescriptions in the three months before and after a medication review. Specifically, we compared the 'prescription count' - the maximum number of different medicines with overlapping prescriptions people had in each period. RESULTS: Of 591,726 people prescribed one or more medicines at baseline, 305,526 (51.6%) had a recorded medication review in 2019. Living in a care home (hazard ratio 1.51, 95% confidence interval 1.40-1.62), medication review in the previous year (1.83, 1.69-1.98), and baseline prescription count (e.g. 5-9 vs 1 medicine 1.41, 1.37-1.46) were strongly associated with having a medication review in 2019. Overall, the prescription count tended to increase after a review (mean change 0.13 medicines, 95% CI 0.12-0.14). CONCLUSIONS: Although medication reviews were commonly recorded for people aged 65 years or over, there was little change overall in the numbers and types of medicines prescribed following a review. This study did not examine whether the prescriptions were appropriate or other metrics, such as dose or medicine changes within the same class. However, by examining the impact of medication reviews before the introduction of structured medication review requirements in England in 2020, it provides a useful benchmark which these new reviews can be compared with. |
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| ジャーナル名 | BMC geriatrics |
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| 投稿日 | 2023/7/14 |
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| 投稿者 | Joseph, Rebecca M; Knaggs, Roger D; Coupland, Carol A C; Taylor, Amelia; Vinogradova, Yana; Butler, Debbie; Gerrard, Louisa; Waldram, David; Iyen, Barbara; Akyea, Ralph K; Ashcroft, Darren M; Avery, Anthony J; Jack, Ruth H |
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| 組織名 | Centre for Academic Primary Care, Lifespan and Population Health, School of;Medicine, University of Nottingham, Nottingham, UK.;National Institute for Health and Care Research Nottingham Biomedical Research;Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.;School of Pharmacy, University of Nottingham, Nottingham, UK.;National Institute for Health and Care Research MindTech MedTech Co-operative,;The Institute of Mental Health, Mental Health and Clinical Neurosciences,;University of Nottingham, Nottingham, UK.;Centre for Pharmacoepidemiology and Drug Safety, Division of Pharmacy and;Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health,;University of Manchester, Manchester, UK.;NIHR Greater Manchester Patient Safety Translational Research Centre, Manchester;Academic Health Science Centre, University of Manchester, Manchester, UK.;Medicine, University of Nottingham, Nottingham, UK. ruth.jack@nottingham.ac.uk.;ruth.jack@nottingham.ac.uk. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/37442984/ |
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