Structured medicines reviews in HIV outpatients: a feasibility study (The MOR Study)
Objectives Polypharmacy in people living with HIV (PLWH) increases the risks of medicine‐related problems (events or circumstances involving drug therapy that actually or potentially interfere with desired health outcomes). We aimed to examine the feasibility and acceptability of a Medicines Managem...
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| Veröffentlicht in: | HIV medicine 2022-01, Vol.23 (1), p.39-47 |
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| creator | Leake Date, Heather A. Alford, Katie Hounsome, Natalia Moore, David Ing, Kin Vera, Jaime H. |
| description | Objectives
Polypharmacy in people living with HIV (PLWH) increases the risks of medicine‐related problems (events or circumstances involving drug therapy that actually or potentially interfere with desired health outcomes). We aimed to examine the feasibility and acceptability of a Medicines Management Optimisation Review (MOR) toolkit in HIV outpatients.
Methods
This was a multi‐centre randomized controlled study across four HIV centres. In all, 200 PLWH on combination antiretroviral therapy, either > 50 years old or |
| doi_str_mv | 10.1111/hiv.13158 |
| format | Article |
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Polypharmacy in people living with HIV (PLWH) increases the risks of medicine‐related problems (events or circumstances involving drug therapy that actually or potentially interfere with desired health outcomes). We aimed to examine the feasibility and acceptability of a Medicines Management Optimisation Review (MOR) toolkit in HIV outpatients.
Methods
This was a multi‐centre randomized controlled study across four HIV centres. In all, 200 PLWH on combination antiretroviral therapy, either > 50 years old or < 50 years with other comorbidities, were enrolled to have a MOR or received standard pharmaceutical care. The primary outcome was the difference in the number of medicine‐related problems (MRPs) between intervention and standard care groups at baseline and 6 months. Acceptability, cost of the intervention and health‐related quality of life were also examined.
Results
In all, 164 patients were analysed: 70 in the intervention group and 94 in the standard care group. A significant number of MRPs were detected in those patients receiving MOR compared with the standard care group at baseline (93 vs. 2; p = 0.001, z = −8.6, r = 0.6) and 6 months (33 vs. 3; p = 0.001, z = −5.7, r = 0.4). A significant reduction in the number of new MRPs at 6 months in the intervention group versus baseline was also observed (p = 0.001, Z = −3.7, r = 0.2); 44% of MRPs were fully resolved at baseline and 51% at 6 months. No changes in health‐related quality of life following MOR or between MOR and standard care groups were observed. The MORs were highly acceptable among patients and healthcare professionals.
Conclusions
The MOR toolkit was feasible and acceptable, suggesting that HIV outpatient services might consider implementing MOR for targeted populations under their care.</description><identifier>ISSN: 1464-2662</identifier><identifier>EISSN: 1468-1293</identifier><identifier>DOI: 10.1111/hiv.13158</identifier><identifier>PMID: 34469628</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Acceptability ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Chemotherapy ; combination antiretroviral therapy ; drug interactions ; Drug therapy ; Feasibility Studies ; Health care ; HIV ; HIV Infections - drug therapy ; Human immunodeficiency virus ; Humans ; medication‐related problems ; Medicine ; Middle Aged ; Optimization ; Outpatients ; Patients ; Polypharmacy ; Quality of Life ; structured medicines reviews ; Toolkits</subject><ispartof>HIV medicine, 2022-01, Vol.23 (1), p.39-47</ispartof><rights>2021 British HIV Association</rights><rights>2021 British HIV Association.</rights><rights>2022 British HIV Association</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3888-1887495568e774a34e368533e573a77f33750c5bf770a762aef21f79f2069303</citedby><cites>FETCH-LOGICAL-c3888-1887495568e774a34e368533e573a77f33750c5bf770a762aef21f79f2069303</cites><orcidid>0000-0003-2037-0685 ; 0000-0002-1165-0573</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhiv.13158$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhiv.13158$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34469628$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leake Date, Heather A.</creatorcontrib><creatorcontrib>Alford, Katie</creatorcontrib><creatorcontrib>Hounsome, Natalia</creatorcontrib><creatorcontrib>Moore, David</creatorcontrib><creatorcontrib>Ing, Kin</creatorcontrib><creatorcontrib>Vera, Jaime H.</creatorcontrib><title>Structured medicines reviews in HIV outpatients: a feasibility study (The MOR Study)</title><title>HIV medicine</title><addtitle>HIV Med</addtitle><description>Objectives
Polypharmacy in people living with HIV (PLWH) increases the risks of medicine‐related problems (events or circumstances involving drug therapy that actually or potentially interfere with desired health outcomes). We aimed to examine the feasibility and acceptability of a Medicines Management Optimisation Review (MOR) toolkit in HIV outpatients.
Methods
This was a multi‐centre randomized controlled study across four HIV centres. In all, 200 PLWH on combination antiretroviral therapy, either > 50 years old or < 50 years with other comorbidities, were enrolled to have a MOR or received standard pharmaceutical care. The primary outcome was the difference in the number of medicine‐related problems (MRPs) between intervention and standard care groups at baseline and 6 months. Acceptability, cost of the intervention and health‐related quality of life were also examined.
Results
In all, 164 patients were analysed: 70 in the intervention group and 94 in the standard care group. A significant number of MRPs were detected in those patients receiving MOR compared with the standard care group at baseline (93 vs. 2; p = 0.001, z = −8.6, r = 0.6) and 6 months (33 vs. 3; p = 0.001, z = −5.7, r = 0.4). A significant reduction in the number of new MRPs at 6 months in the intervention group versus baseline was also observed (p = 0.001, Z = −3.7, r = 0.2); 44% of MRPs were fully resolved at baseline and 51% at 6 months. No changes in health‐related quality of life following MOR or between MOR and standard care groups were observed. The MORs were highly acceptable among patients and healthcare professionals.
Conclusions
The MOR toolkit was feasible and acceptable, suggesting that HIV outpatient services might consider implementing MOR for targeted populations under their care.</description><subject>Acceptability</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Chemotherapy</subject><subject>combination antiretroviral therapy</subject><subject>drug interactions</subject><subject>Drug therapy</subject><subject>Feasibility Studies</subject><subject>Health care</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>medication‐related problems</subject><subject>Medicine</subject><subject>Middle Aged</subject><subject>Optimization</subject><subject>Outpatients</subject><subject>Patients</subject><subject>Polypharmacy</subject><subject>Quality of Life</subject><subject>structured medicines reviews</subject><subject>Toolkits</subject><issn>1464-2662</issn><issn>1468-1293</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1PAjEQhhujEUQP_gHTxIscFvqx23a9GaJCgiGRjdemLN1QArvYdiH77y0senMuM5M8eWfyAHCP0QCHGq7MfoApTsQF6OKYiQiTlF6e5jgijJEOuHFujRDmNEXXoEPjmKWMiC7I5t7Wua-tXsKtXprclNpBq_dGHxw0JRxPvmBV-53yRpfePUMFC62cWZiN8Q10vl428Clbafgx-4Tz49q_BVeF2jh9d-49kL29ZqNxNJ29T0Yv0yinQoQvheBxmiRMaM5jRWNNmUgo1QmnivOCUp6gPFkUnCPFGVG6ILjgaUEQSymiPfDYxu5s9V1r5-W6qm0ZLkrCcJxgLoKHHui3VG4r56wu5M6arbKNxEge9cmgT570BfbhnFgvgo0_8tdXAIYtcDAb3fyfJIO2NvIHqwJ3BA</recordid><startdate>202201</startdate><enddate>202201</enddate><creator>Leake Date, Heather A.</creator><creator>Alford, Katie</creator><creator>Hounsome, Natalia</creator><creator>Moore, David</creator><creator>Ing, Kin</creator><creator>Vera, Jaime H.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><orcidid>https://orcid.org/0000-0003-2037-0685</orcidid><orcidid>https://orcid.org/0000-0002-1165-0573</orcidid></search><sort><creationdate>202201</creationdate><title>Structured medicines reviews in HIV outpatients: a feasibility study (The MOR Study)</title><author>Leake Date, Heather A. ; Alford, Katie ; Hounsome, Natalia ; Moore, David ; Ing, Kin ; Vera, Jaime H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-1887495568e774a34e368533e573a77f33750c5bf770a762aef21f79f2069303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acceptability</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Chemotherapy</topic><topic>combination antiretroviral therapy</topic><topic>drug interactions</topic><topic>Drug therapy</topic><topic>Feasibility Studies</topic><topic>Health care</topic><topic>HIV</topic><topic>HIV Infections - drug therapy</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>medication‐related problems</topic><topic>Medicine</topic><topic>Middle Aged</topic><topic>Optimization</topic><topic>Outpatients</topic><topic>Patients</topic><topic>Polypharmacy</topic><topic>Quality of Life</topic><topic>structured medicines reviews</topic><topic>Toolkits</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Leake Date, Heather A.</creatorcontrib><creatorcontrib>Alford, Katie</creatorcontrib><creatorcontrib>Hounsome, Natalia</creatorcontrib><creatorcontrib>Moore, David</creatorcontrib><creatorcontrib>Ing, Kin</creatorcontrib><creatorcontrib>Vera, Jaime H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>HIV medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Leake Date, Heather A.</au><au>Alford, Katie</au><au>Hounsome, Natalia</au><au>Moore, David</au><au>Ing, Kin</au><au>Vera, Jaime H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Structured medicines reviews in HIV outpatients: a feasibility study (The MOR Study)</atitle><jtitle>HIV medicine</jtitle><addtitle>HIV Med</addtitle><date>2022-01</date><risdate>2022</risdate><volume>23</volume><issue>1</issue><spage>39</spage><epage>47</epage><pages>39-47</pages><issn>1464-2662</issn><eissn>1468-1293</eissn><abstract>Objectives
Polypharmacy in people living with HIV (PLWH) increases the risks of medicine‐related problems (events or circumstances involving drug therapy that actually or potentially interfere with desired health outcomes). We aimed to examine the feasibility and acceptability of a Medicines Management Optimisation Review (MOR) toolkit in HIV outpatients.
Methods
This was a multi‐centre randomized controlled study across four HIV centres. In all, 200 PLWH on combination antiretroviral therapy, either > 50 years old or < 50 years with other comorbidities, were enrolled to have a MOR or received standard pharmaceutical care. The primary outcome was the difference in the number of medicine‐related problems (MRPs) between intervention and standard care groups at baseline and 6 months. Acceptability, cost of the intervention and health‐related quality of life were also examined.
Results
In all, 164 patients were analysed: 70 in the intervention group and 94 in the standard care group. A significant number of MRPs were detected in those patients receiving MOR compared with the standard care group at baseline (93 vs. 2; p = 0.001, z = −8.6, r = 0.6) and 6 months (33 vs. 3; p = 0.001, z = −5.7, r = 0.4). A significant reduction in the number of new MRPs at 6 months in the intervention group versus baseline was also observed (p = 0.001, Z = −3.7, r = 0.2); 44% of MRPs were fully resolved at baseline and 51% at 6 months. No changes in health‐related quality of life following MOR or between MOR and standard care groups were observed. The MORs were highly acceptable among patients and healthcare professionals.
Conclusions
The MOR toolkit was feasible and acceptable, suggesting that HIV outpatient services might consider implementing MOR for targeted populations under their care.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34469628</pmid><doi>10.1111/hiv.13158</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-2037-0685</orcidid><orcidid>https://orcid.org/0000-0002-1165-0573</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Acceptability Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Chemotherapy combination antiretroviral therapy drug interactions Drug therapy Feasibility Studies Health care HIV HIV Infections - drug therapy Human immunodeficiency virus Humans medication‐related problems Medicine Middle Aged Optimization Outpatients Patients Polypharmacy Quality of Life structured medicines reviews Toolkits |
| title | Structured medicines reviews in HIV outpatients: a feasibility study (The MOR Study) |
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