Skip to main content

Advertisement

SpringerLink
Log in

Retrospective examination of selected outcomes of Medicines Use Review (MUR) services in New Zealand

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

Abstract

Background Poor adherence to medication can lead to suboptimal outcomes, and is reported to occur frequently. Pharmacists in some countries are funded to support the appropriate use of medications in patients and enhance medication adherence, by providing services such as Medicines Use Review (MUR). Objective To describe and investigate factors that may influence patients’ knowledge and perceptions of and adherence to medications as determined during MUR. Setting Community pharmacies in a locality in New Zealand. Method Following consent from five MUR service providers, records of patients’ MUR consultations conducted between November 2007 and December 2011 were retrospectively reviewed for information on patients, services, and outcomes. Using multilevel mixed-effects logistic regression, factors that predicted the providers’ score of the patients’ medication knowledge, and the patients’ score of their adherence to and perceptions of medications, were investigated. Main outcome measure patients’ knowledge, perceptions and adherence scores. Results A total of 353 MUR patients’ records were evaluated. The median (IQR) age of patients was 73 (63–81) years. About 41.1 % of patients were Māori. A total of 204 (57.8 %) patients had two MUR consultations and only 53 (15 %) had four. The mean score of patients’ knowledge, perceptions of, and adherence to medications were found to increase in each visit which suggests that adherence support by pharmacists might improve patients’ outcomes. Females had higher medication knowledge scores than males (OR 3.09, 95 % CI 1.29–7.44). There was some evidence to suggest Māori had lower scores for knowledge of medications than non-Māori (OR 0.092, 95 % CI 0.02–0.36). In addition, longer duration in the program predicted better scores for medication knowledge, adherence and perceptions of medications. Conclusions MUR was found to have the potential to improve the scores of patients’ knowledge and perceptions of and adherence to medicines, and factors such as gender, ethnicity and longer duration in the services were found to predict these outcomes.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ho P, Bryson CL, Rumsfeld JS. Medication adherence: its importance in cardiovascular outcomes. Circulation. 2009;119(23):3028–35.

    Article  PubMed  Google Scholar 

  2. World Health Organization. Adherence to long-term therapies: evidence for action, 2003. [cited 2013 Aug 24]. http://www.who.int/chp/knowledge/publications/adherence_report/en/.

  3. New England Health Institute. Thinking outside the pillbox: A system-wide approach to improving patient medication adherence for chronic disease, 2009. [cited 2013 Aug 24]. http://www.nehi.net/publications/44/thinking_outside_the_pillbox_a_systemwide_approach_to_improving_patient_medication_adherence_for_chronic_disease.

  4. Dunbar-Jacob J, Erlen JA, Schlenk EA, Ryan CM, Sereika SM, Doswell WM. Adherence in chronic disease. Annu Rev Nurs Res. 2000;18:48–90.

    CAS  PubMed  Google Scholar 

  5. Clyne W, Blenkinsopp A and Seal R. A Guide to Medication Review, 2008. [cited 2013 Aug 24]. http://www.npc.nhs.uk/review_medicines/intro/resources/agtmr_web1.pdf.

  6. District Health Board New Zealand. New Zealand National Pharmacist Services Framework, 2007. [cited 2013 Aug 24]. http://www.psnz.org.nz/public/cop/documents/dhbnzpharmacistservicesframework2007.pdf.

  7. District Health Board Shared Services. New Zealand National Pharmacist Services Framework, 2007. [cited 2013 Aug 24]. http://www.dhbsharedservices.health.nz/Site/SIG/NPSF/NPSF-Framework.aspx.

  8. Brandt T, Harrison J, Sheridan J, Shaw J, Jensen M. The evaluation of auckland District Health Board’s medicines use review pilot: the ADMiRE Report, 2009. [cited 2013 Aug 24]. http://www.adhb.govt.nz/PHO/documents/ADMiRE%20report%20final.pdf.

  9. Lee E, Braund R, Tordoff J. Examining the first year of medicines use review services provided by pharmacist in New Zealand. N Z Med J. 2009;122(1293):26–35.

    Google Scholar 

  10. Cipolle R, Strand L, Morley P. Pharmaceutical care practice: the patient centered approach to medication management. 3rd ed. The United States of America: McGraw-Hill companies; 2012. ISBN 978-0-07-179086-4.

    Google Scholar 

  11. Asam L, Boardman HF, Pollock K. Understanding the patient perspective of the english community pharmacy medicines use review (MUR). Res Soc Admin. 2013;9:949–57.

    Article  Google Scholar 

  12. Statistics New Zealand, 2006 Census. [cited 2013 Aug 24]. http://www.stats.govt.nz/Census/2006CensusHomePage.aspx.

  13. Hatah E, Tordoff J, Duffull S, Braund R. Pharmacists’ performance of clinical interventions during adherence support medication reviews. Res in Soc and Admin Pharm (article in press). http://dx.doi.org/10.1016/j.sapharm.2013.04.008.

  14. StataCorp. Stata Statistical Software: Release 12, StataCorp LP2011: College Station, TX.

  15. Barat I, Andreasen F, Damsgaard EM. The consumption of drugs by 75-year-old individuals living in their own homes. Eur J Clin Pharmacol. 2000;56(6–7):501–9.

    Article  CAS  PubMed  Google Scholar 

  16. Tordoff JM, Bagge ML, Gray AR, Campbell AJ, Norris PT. Medicine-taking practices in community-dwelling people aged > or = 75 years in New Zealand. Age Ageing. 2010;39(5):574–80.

    Article  PubMed  Google Scholar 

  17. Guaraldo L, Cano FG, Damasceno GS, Rozenfeld S. Inappropriate medication use among the elderly: a systematic review of administrative databases. BMC Geriatr. 2011;11(1):79.

    Article  PubMed Central  PubMed  Google Scholar 

  18. Ahmad NS, Ramli A, Islahudin F, Paraidathathu T. Medication adherence in patients with type 2 diabetes mellitus treated at primary health clinics in Malaysia. Patient Prefer Adherence. 2013;7:525–30.

    PubMed Central  PubMed  Google Scholar 

  19. Krien SL, Heisler M, Piette JD, Makki F, Kerr EA. The effect of chronic pain on diabetes patients’ self-management. Diabetes Care. 2005;28(1):65–70.

    Article  Google Scholar 

  20. Witticke D, Seidling H, Lohmann K, Send A, Haefeli W. Opportunities to reduce medication complexity: a retrospective analysis of patients discharged from a university hospital in Germany. Drug Saf. 2013;36(1):31–41.

    Article  PubMed  Google Scholar 

  21. Lam PW, Lum CM, Leung MF. Drug non-adherence and associated risk factors among Chinese geriatric patients in Hong Kong. Hong Kong Med J. 2007;13(4):284–92.

    CAS  PubMed  Google Scholar 

  22. Burge S, White D, Bajorek E, Bazaldua O, Trevino J, Albright T, et al. Correlates of medication knowledge and adherence: findings from the residency research network of South Texas. Fam Med. 2005;37(10):712–8.

    PubMed  Google Scholar 

  23. Kalichman SC, Ramachandran B, Catz S. Adherence to combination antiretroviral therapies in HIV patients of low health literacy. J Gen Intern Med. 1999;14(5):267–73.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  24. Kalichman SC, Rompa D. Functional health literacy is associated with health status and health-related knowledge in people living with HIV-AIDS. J Acquir Immune Defic Syndr. 2000;25(4):337–44.

    Article  CAS  PubMed  Google Scholar 

  25. Ministry of Health New Zealand. Health literacy and Maori results from the 2006 adult literacy and life skills survey. [cited 2013 Aug 24]. http://www.health.govt.nz/publication/korero-marama-health-literacy-and-maori-results-2006-adult-literacy-and-life-skills-survey.

  26. Erickson S, Slaughter R, Halapy H. Pharmacists’ ability to influence outcomes of hypertension therapy. Pharmacother. 1997;17(1):140–7.

    CAS  Google Scholar 

  27. Hawkins D, Bradberry JC, Cziraky MJ, Talbert RL, Bartels DW, Cerveny JD. National pharmacy cardiovascular council treatment guidelines for the management of Type 2 diabetes Mellitus: toward better patient outcomes and new roles for pharmacists. Pharmacother. 2002;22(4):436–44.

    Article  Google Scholar 

  28. Al-Qazaz H, Sulaiman SA, Hassali MA, Shafie AA, Sundram S, Al-Nuri R, et al. Diabetes knowledge, medication adherence and glycemic control among patients with type 2 diabetes. Int J Clin Pharm. 2011;33(6):1028–35.

    Article  PubMed  Google Scholar 

  29. Coulter A, Parsons S and Askham J. Policy brief: where are the patients in decision-making about their own care?, 2008. [cited 2013 Aug 24]. http://www.who.int/management/general/decisionmaking/WhereArePatientsinDecisionMaking.pdf.

  30. Fairman K and Motheral B. Evaluating medication adherence: which measure is right for your program? J Managed Care Pharmacy. 2000;6(6):499-504.

    Google Scholar 

Download references

Acknowledgments

We would like to thank the MUR coordinator and the community pharmacists who participated in this study and helped us with the data collections.

Funding

Funding for this study was provided by the School of Pharmacy, University of Otago. EH was supported by scholarship from Universiti Kebangsaan Malaysia and Ministry of Higher Education Malaysia.

Conflicts of interest

None to declare.

Author information

Authors and Affiliations

  1. School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand

    Ernieda Hatah, June Tordoff, Stephen B. Duffull & Rhiannon Braund

  2. Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

    Ernieda Hatah

  3. Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Claire Cameron

Authors
  1. Ernieda Hatah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. June Tordoff
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stephen B. Duffull
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claire Cameron
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rhiannon Braund
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ernieda Hatah.

Appendices

Appendix 1

See Table 5.

Table 5 The results of univariate analysis of the variables that might be important in the modelling of patients’ knowledge, perceptions of, and adherence to medications
Full size table

Appendix 2

See Table 6.

Table 6 Comparison of scores between patients who continue the program with who did not have a further visit
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hatah, E., Tordoff, J., Duffull, S.B. et al. Retrospective examination of selected outcomes of Medicines Use Review (MUR) services in New Zealand. Int J Clin Pharm 36, 503–512 (2014). https://doi.org/10.1007/s11096-014-9913-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-014-9913-1

Keywords

Search

Navigation