Skip to main content
Log in

Awareness and use of medication management services in relation to medication adherence prior to hospitalisation among older adults in Regional Australia

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Background Ageing is associated with changes in physiology, functional ability, declined in cognition and multiple co-morbidities. Alterations in pharmacodynamic and pharmacokinetic aspects also occur. Medications can improve the quality of life in people with multiple co-morbidities; polypharmacy and ageing could increase risks of medication misadventures and adverse events leading to hospital admissions. Medication management services (MedsCheck, Diabetes MedsCheck and Home Medication Review) were implemented in Australia to: increase patients’ knowledge about their medicines, increase patients’ confidence in using their medicines, and reduce avoidable hospital admissions. Objective This study aims to investigate patients’ awareness, understanding and uptake of medication management services in relation to medication adherence. Setting Study was conducted at the Maryborough hospital, Queensland, Australia. Method This was a questionnaire based prospective study. A questionnaire was developed based on the questions used in the evaluation of the MedsCheck and Diabetes MedsCheck pilot program. Main outcome/Result We identified 243 participants of which 198 patients agreed to participate. Of the participants, 68.1% were taking more than five different medications a day and 34.3% of participants were taking more than 10 different medications a day. Those that consumed five or more doses of medication a day constitutes 72%. Only 3% had accessed medication management services prior to hospital admission. Many of participants (76.3%) noted that they had issues with different generics/brands of medication and only 23.2% of participants stated that they had a good understanding of drug–drug interactions. Conclusion Hospitalised patients are unaware of medication management services that could reduce frequency of re-hospitalisation. Community and hospital pharmacists can play a major role increasing patients’ awareness of the availability of these services.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Atkins MT, Tonts M. Exploring cities through a population ageing matrix: a spatial and temporal analysis of older adult population trends in Perth, Australia. Aust Geogr. 2016;47(1):65–87.

    Article  Google Scholar 

  2. Australian Institute of Health and Welfare. Australia’s health 2016. Canberra: AIHW; 2016.

    Google Scholar 

  3. Morgan TK, Williamson M, Pirotta M, Stewart K, Myers SP, Barnes J. A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older. Med J Aust. 2012;196(1):50–3.

    Article  Google Scholar 

  4. Colloca G, Santoro M, Gambassi G. Age-related physiologic changes and perioperative management of elderly patients. Surg Oncol. 2010;19(3):124–30.

    Article  Google Scholar 

  5. Sera LC, McPherson ML. Pharmacokinetics and pharmacodynamic changes associated with aging and implications for drug therapy. Clin Geriatr Med. 2012;28(2):273–86.

    Article  Google Scholar 

  6. Burgess CL, Holman CD, Satti AG. Adverse drug reactions in older Australians, 1981–2002. Med J Aust. 2005;182(6):267–70.

    PubMed  Google Scholar 

  7. Nivya K, Sri Sai Kiran V, Ragoo N, Jayaprakash B, Sonal Sekhar M. Systemic review on drug related hospital admissions—a pubmed based search. Saudi Pharm J. 2015;23(1):1–8.

    Article  Google Scholar 

  8. Schnipper JL, Kirwin JL, Cotugno MC, Wahlstrom SA, Brown BA, Tarvin E, et al. Role of pharmacist counseling in preventing adverse drug events after hospitalization. Arch Intern Med. 2006;166(5):565–71.

    Article  Google Scholar 

  9. Tam KW, Kwok KH, Fan YM, Tsui KB, Ng KK, Ho KY, et al. Detection and prevention of medication misadventures in general practice. Int J Qual Health Care. 2008;20(3):192–9.

    Article  Google Scholar 

  10. Roughead EE, Semple SJ, Rosenfeld E. The extent of medication errors and adverse drug reactions throughout the patient journey in acute care in Australia. Int J Evid based Healthc. 2016;14(3):113–22.

    Article  Google Scholar 

  11. Campbell Research & Consulting. Home medicines review program qualitative research project: final report 2008. In: Ageing DoHa, editor. 2008.

  12. Elliott Rohan A. Problems with medication use in the elderly: an Australian perspective. J Pharm Pract Res. 2015;36(1):58–66.

    Article  Google Scholar 

  13. Roughead EE, Semple SJ. Medication safety in acute care in Australia: where are we now? Part 1: a review of the extent and causes of medication problems 2002-2008. Aust N Z Health Policy. 2009;6:18.

    Article  Google Scholar 

  14. Crotty M, Rowett D, Spurling L, Giles LC, Phillips PA. Does the addition of a pharmacist transition coordinator improve evidence-based medication management and health outcomes in older adults moving from the hospital to a long-term care facility? Results of a randomized, controlled trial. Am J Geriatr Pharmacother. 2004;2(4):257–64.

    Article  Google Scholar 

  15. Deloitte Access Economics. Evaluation of the MedsCheck and Diabetes MedsCheck pilot program. In: Health Do, editor. Australia; 2012.

  16. Australian Government Department of Health. Implementation of a hospital referral pathway to enable urgent Home Medicines Reviews (HMR). In: Health Do, editor.: Department of Health; 2012.

  17. The 6CPA. FAQ—ensuring sustainability and delivering efficiencies Australia: The 6CPA; 2014. Available from: http://6cpa.com.au/2014/02/faq-ensuring-sustainability-and-delivering-efficiencies/.

  18. Shafiee Hanjani L, Apostolidis A, Winckel K, Burrows JA. An evaluation of the utilisation of the Medication Action Plan form in a tertiary hospital: what is the impact of the pharmacist? J Pharm Pract Res. 2017;47(4):257–62.

    Article  Google Scholar 

  19. Department of Health. Medicare Benefits Schedule Book. 2018. Available from: http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Downloads-201812.

  20. Vajdic CM, Stavrou EP, Ward RL, Falster MO, Pearson SA. Minimal excess risk of cancer and reduced risk of death from cancer in Australian Department of Veterans’ Affairs clients: a record linkage study. Aust N Z J Public Health. 2014;38(1):30–4.

    Article  Google Scholar 

  21. Barrett LL. Prescription drug use among midlife and older Americans. Washington, D.C.: AARP, Knowledge Management; 2005.

    Google Scholar 

  22. Dhillon AK, Hattingh HL, Stafford A, Hoti K. General practitioners’ perceptions on home medicines reviews: a qualitative analysis. BMC Fam Pract. 2015;16(1):16.

    Article  Google Scholar 

  23. Jokanovic N, Tan EC, Van den Bosch D, Kirkpatrick CM, Dooley MJ, Bell JS. Clinical medication review in Australia: a systematic review. Res Soc Adm Pharm. 2016;12(3):384–418.

    Article  Google Scholar 

  24. Rochon PA. Drug Prescribing for Older Adults. UpToDate, 2017. Available from: www.uptodate.com/contents/drug-prescribing-for-older-adults.

  25. Wimmer BC, Cross AJ, Jokanovic N, Wiese MD, George J, Johnell K, et al. Clinical outcomes associated with medication regimen complexity in older people: a systematic review. J Am Geriatr Soc. 2017;65(4):747–53.

    Article  Google Scholar 

  26. Huang ES, Karter AJ, Danielson KK, Warton EM, Ahmed AT. The association between the number of prescription medications and incident falls in a multi-ethnic population of adult type-2 diabetes patients: the diabetes and aging study. J Gen Intern Med. 2010;25(2):141–6.

    Article  Google Scholar 

  27. Sorensen L, Stokes JA, Purdie DM, Woodward M, Elliott R, Roberts MS. Medication reviews in the community: results of a randomized, controlled effectiveness trial. Br J Clin Pharmacol. 2004;58(6):648–64.

    Article  Google Scholar 

  28. Gabbay U, Yosef N, Feder-Krengel N, Meyerovitch J. Therapeutic equivalent substitute that is new or unfamiliar to the chronic patient may result in medication error. Int J Health Care Qual Assur. 2012;25(6):509–18.

    Article  Google Scholar 

  29. Kesselheim AS, Misono AS, Shrank WH, Greene JA, Doherty M, Avorn J, et al. Variations in pill appearance of antiepileptic drugs and the risk of nonadherence. JAMA Intern Med. 2013;173(3):202–8.

    Article  Google Scholar 

Download references

Acknowledgements

Special thanks to Mr. Glen Tapley, the Director of Pharmacy at the Wide Bay Hospital and Health Service (Fraser Coast) for approving the time needed to complete this project.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Adeleke D. Adewumi.

Ethics declarations

Funding

None.

Conflicts of interest

Authors K.P.L. and A.D.A declare that they have no conflict of interest.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 18 kb)

Supplementary material 2 (DOC 236 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lau, K.P., Adewumi, A.D. Awareness and use of medication management services in relation to medication adherence prior to hospitalisation among older adults in Regional Australia. Int J Clin Pharm 41, 189–197 (2019). https://doi.org/10.1007/s11096-018-0765-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-018-0765-y

Keywords

Navigation