Primary studies included in this systematic review

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Primary study

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A pharmacy discharge plan for hospitalized elderly patients--a randomized controlled trial.

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Journal Age and ageing
Year 2001
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OBJECTIVES: to investigate the effectiveness of a pharmacy discharge plan in elderly hospitalized patients. DESIGN: randomized controlled trial. SUBJECTS AND SETTINGS: we randomized patients aged 75 years and older on four or more medicines who had been discharged from three acute general and one long-stay hospital to a pharmacy intervention or usual care. INTERVENTIONS: the hospital pharmacist developed discharge plans which gave details of medication and support required by the patient. A copy was given to the patient and to all relevant professionals and carers. This was followed by a domiciliary assessment by a community pharmacist. In the control group, patients were discharged from hospital following standard procedures that included a discharge letter to the general practitioner listing current medications. OUTCOMES: the primary outcome was re-admission to hospital within 6 months. Secondary outcomes included the number of deaths, attendance at hospital outpatient clinics and general practice and proportion of days in hospital over the follow-up period, together with patients' general well-being, satisfaction with the service and knowledge of and adherence to prescribed medication. RESULTS: we recruited 362 patients, of whom 181 were randomized to each group. We collected hospital and general practice data on at least 91 and 72% of patients respectively at each follow-up point and interviewed between 43 and 90% of the study subjects. There were no significant differences between the groups in the proportion of patients re-admitted to hospital between baseline and 3 months or 3 and 6 months. There were no significant differences in any of the secondary outcomes. CONCLUSIONS: we found no evidence to suggest that the co-ordinated hospital and community pharmacy care discharge plans in elderly patients in this study influence outcomes.

Primary study

Unclassified

Effects of a medicine review and education programme for older people in general practice.

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Journal British journal of clinical pharmacology
Year 2000
Links Pubmed DOI PubMed Central
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AIMS: To determine whether a medicine review and education programme influences the compliance and knowledge of older people in general practice. METHODS: Older people taking at least three medicines were randomly allocated to a control or intervention group. Both groups received three visits from a clinical pharmacist: Visit 1: Assessment and patients' medicines rationalized in intervention group. Visit 2: Intervention group given medicines education. Visit 3: Knowledge and compliance in both groups assessed by structured questionnaire RESULTS: Compliance in the intervention group was 91.3%, compared with 79.5% in the control group (P < 0.0001). The number of intervention group patients correctly understanding the purpose of their medicines increased from 58% to 88% on the second visit, compared with 67% to 70% in the control group (P < 0.0005). CONCLUSIONS: A general practice based medication review and education programme improved medicine compliance and knowledge of older people in the short term.

Primary study

Unclassified

The effects of medication education on adherence to medication regimens in an elderly population.

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Authors Esposito L
Journal Journal of advanced nursing
Year 1995
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The purpose of this intervention study was to evaluate educational protocols to see which would be more effective in increasing medication compliance rates within an elderly population. Forty-two patients were randomized into four groups. Group 1 received a standard education protocol; group 2 received the standard education and 30 minutes of verbal instruction; group 3 received the standard education and a medication schedule; and group 4 received the standard education, a medication schedule, and 30 minutes of verbal instruction. The intervention was given on the day of hospital discharge. Home visits were made 2 weeks, 1 and 2 months post-hospital discharge. Results of the visits revealed that groups 1 and 2 had higher rates of errors with medications than groups 3 and 4. In conclusion, the groups with a medication schedule had higher compliance rates. Considering the sample size of 42, this study can act as a pilot study to justify further research in the effects of a medication schedule on compliance.

Primary study

Unclassified

The impact of clinical pharmacists' consultations on geriatric patients' compliance and medical care use: a randomized controlled trial.

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Authors Lipton HL , Bird JA
Journal The Gerontologist
Year 1994
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This study assessed the impact of clinical pharmacists' consultations on drug regimens, compliance, and health service use of geriatric hospitalized patients (N = 706) discharged on 3 or more medications. Pharmacists consulted with experimental patients at discharge and 3 months thereafter, and with physicians as needed. Controls received usual care. At 6-8 weeks after enrollment, experimental patients were more knowledgeable about regimens than controls. At 12-14 weeks, they were on fewer medications and less complex regimens, and had better compliance scores. There was no effect on service use or charges, perhaps due to inadequate sample size and lack of targeted drug groups analysis. The authors conclude that clinical pharmacists' consultations can improve geriatric patients' drug regimens and compliance. Findings further suggest the need for replication among large cohorts of patients at high risk, due to the use of medications most likely to have a potential for serious outcomes and to be vulnerable to physician prescribing error.

Primary study

Unclassified

Medication counseling for the elderly: effects on knowledge and compliance after hospital discharge.

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Authors Wolfe SC , Schirm V
Journal Geriatric nursing (New York, N.Y.)
Year 1992
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The findings from the instruments used in this study and the additional qualitative data of the personal interviews provide information helpful to the nurse's understanding of medication knowledge and compliance patterns in older persons. Investigations that study older persons over time are needed to identify how behaviors change. Such studies would also be helpful in identifying self-care behaviors learned over extended periods of time. It may also be helpful to investigate knowledge and compliance behaviors in the home setting, where the environment may be more conducive to learning. With the patient assuming more and more responsibility for self-care, it is imperative that professionals explore all opportunities to assist patients in acquiring the skills essential to promoting their own well-being.

Primary study

Unclassified

Unit dose calendar packaging and elderly patient compliance.

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Journal The New Zealand medical journal
Year 1991
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A controlled trial of the effect of a unit dose system of tablet/capsule calendar packaging (Webster-Pak) on the rate of successful self medication both in hospital and after discharge to the community has been completed in a geriatric assessment and rehabilitation unit. Eighty-four elderly patients, 45 using calendar packs (study), and 39 using conventional bottles or packs (control), were followed for three months after discharge. There was a significant improvement in patient compliance in the study group over controls on discharge (86.7% vs 66.7%), 10 days (68.8% vs 41.0%), one month (64.4% vs 38.5%) and three months (48.9% vs 23.1%) after discharge. Unit dose packaging is a cost effective method of improving the delivery of medicine in elderly patients, and should be available as part of the health budget.