1.What Do Older Adults and Their Caregivers in Malaysia Think of Home Medication Review? A Qualitative Inquiry
Ahlam Sundus ; Tan Maw Pin ; Renukha Sellappans
Malaysian Journal of Medicine and Health Sciences 2022;18(No.1):99-104
Introduction: Home medication review (HMR) involves a patient-centered approach, extending continuity of care
to the community setting with the intention of improving medication use and health outcome. The delivery of HMR
services in Malaysia remains limited to urban hospitals and clinics. Current study aimed to explore the perception
and acceptability of HMR in older adults. Methods: In-depth individual interviews were conducted among adults
aged ≥65 years old, taking ≥5 medications, recruited from geriatrics clinics at a tertiary teaching hospital. Home
interviews were conducted among 12 older adults and care givers between April to June 2019. Interviews were audio-taped, transcribed verbatim and analysed through descriptive interpretive approach of qualitative data analysis.
Results: HMR provided participants with opportunities to discuss medication-related issues with pharmacists in conducive environments. Pharmacists provided information which improved knowledge on indications, dosages and
safe storage of medications through HMR. Participants experienced relief and developed confidence in medication
self-management. Conclusion: The importance of follow-up visits to ensure adequate monitoring and continuity of
care were emphasized. Larger quantitative studies are required to determine the clinical impact and cost-effectiveness of HMR to justify the implementation and expansion of this service
2.DRUG-RELATED PROBLEMS ENCOUNTERED BY COMMUNITY-DWELLING OLDER PERSONS IN THE KLANG VALLEY, MALAYSIA: AN EXPLORATORY STUDY
Ahlam Sundus ; Maw Pin Tan ; Renukha Sellappans
Journal of University of Malaya Medical Centre 2021;24(1):63-69
Introduction:
The population of Malaysia is ageing rapidly. Due to the relatively greater incidence of noncommunicable diseases among older adults, polypharmacy is highly prevalent in this population. This polypharmacy along with other age-related factors increases the risk of drug-related problems to several folds. Currently, no study in Malaysia or even Asia has determined the type and nature of drug-related problems among non-institutionalised older adults. Therefore, this study aims to highlight common drug-related problems among community-dwelling older persons (≥ 65 years) with polypharmacy.
Materials and Methods:
A cross-sectional exploratory study was carried out where in-depth home medication reviews were carried out by two pharmacists. Participants were recruited from geriatric and fall clinics of the University of Malaya Medical Centre located in the urban area of the Federal Territory of Malaysia. The total numbers of drug-related problems were classified using the Pharmaceutical Care Network Europe (PCNE) classification V9.0. Recommendations and referral letters were provided based on the pharmaceutical care issues identified.
Results:
Thirty participants were recruited, among whom 178 drug-related problems were identified with a median value of six [range 1-11] drug-related problems per participant. The majority of problems were related to the effectiveness of prescribed treatment (69.1 %), followed by the possibility of adverse effects (28.7 %).
Conclusion
Home medication review identifies numerous medication-related issues and allows for patient education and detailed counselling in an informal and patient-friendly manner. Future studies to determine the longitudinal effect of home medication review on patient outcome, cost implications, and overall healthcare utilization are now indicated.
Medication Review
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Aged
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Pharmacist