Factors affecting the delivery of community pharmacist-led medication reviews: evidence from the MedsCheck annual service in Ontario

Petros Pechlivanoglou, Lusine Abrahamyan, Linda MacKeigan, Giulia P Consiglio, Lisa Dolovich, Ping Li, Suzanne M Cadarette, Valeria E Rac, Jonghyun Shin, Murray Krahn, Petros Pechlivanoglou, Lusine Abrahamyan, Linda MacKeigan, Giulia P Consiglio, Lisa Dolovich, Ping Li, Suzanne M Cadarette, Valeria E Rac, Jonghyun Shin, Murray Krahn

Abstract

Background: Medication reviews have become part of pharmacy practice across developed countries. This study aimed to identify factors affecting the likelihood of eligible Ontario seniors receiving a pharmacy-led medication review called MedsCheck annual (MCA).

Methods: We designed a cohort study using a random sample of pharmacy claims for MCA-eligible Ontario seniors using linked administrative data from April 2012 to March 2013. Guided by a conceptual framework, we constructed a generalized-estimating-equations model to estimate the effect of patient, pharmacy and community factors on the likelihood of receiving MCA.

Results: Of the 2,878,958 eligible claim-dates, 65,605 included an MCA. Compared to eligible individuals who did not receive an MCA, recipients were more likely to have a prior MCA (OR = 3.03), receive a new medication on the claim-date (OR = 1.78), be hypertensive (OR = 1.18) or have a recent hospitalization (OR = 1.07). MCA recipients had fewer medications (e.g., OR = 0.44 for ≥12 medications versus 0-4 medications), and were less likely to receive an MCA in a rural (OR = 0.74) or high-volume pharmacy (OR = 0.65).

Conclusions: The most important determinant of receiving an MCA was having had a prior MCA. Overall, MCA recipients were healthier, younger, urban-dwelling, and taking fewer medications than non-recipients. Policies regarding current and future medication review programs may need to evolve to ensure that those at greatest need receive timely and comprehensive medication reviews.

Keywords: Community; Elderly; Medication review; Pharmacy; Predictors.

Figures

Fig. 1
Fig. 1
Conceptual framework of observed and latent predictors for utilization of MCA services MCA, MedsCheck Annual; SES, socio-economic status
Fig. 2
Fig. 2
Flowchart of study sample selection. ODB: Ontario Drug Database, MCA: Medscheck Annual, LTC: long-term care

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Source: PubMed

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