Publication

Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review: A randomised controlled trial

van der Meer, H. G., Wouters, H., Pont, L. G. & Taxis, K., 19-Jul-2018, In : BMJ Open. 8, 7, p. e019042

Research output: Contribution to journalArticleAcademicpeer-review

APA

van der Meer, H. G., Wouters, H., Pont, L. G., & Taxis, K. (2018). Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review: A randomised controlled trial. BMJ Open, 8(7), e019042. https://doi.org/10.1136/bmjopen-2017-019042

Author

van der Meer, Helene G ; Wouters, Hans ; Pont, Lisa G ; Taxis, Katja. / Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review : A randomised controlled trial. In: BMJ Open. 2018 ; Vol. 8, No. 7. pp. e019042.

Harvard

van der Meer, HG, Wouters, H, Pont, LG & Taxis, K 2018, 'Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review: A randomised controlled trial', BMJ Open, vol. 8, no. 7, pp. e019042. https://doi.org/10.1136/bmjopen-2017-019042

Standard

Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review : A randomised controlled trial. / van der Meer, Helene G; Wouters, Hans; Pont, Lisa G; Taxis, Katja.

In: BMJ Open, Vol. 8, No. 7, 19.07.2018, p. e019042.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

van der Meer HG, Wouters H, Pont LG, Taxis K. Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review: A randomised controlled trial. BMJ Open. 2018 Jul 19;8(7):e019042. https://doi.org/10.1136/bmjopen-2017-019042


BibTeX

@article{91be997b7fbf4d7f91c5ff9025a9036d,
title = "Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review: A randomised controlled trial",
abstract = "OBJECTIVE: To evaluate if a pharmacist-led medication review is effective at reducing the anticholinergic/sedative load, as measured by the Drug Burden Index (DBI).DESIGN: Randomised controlled single blind trial.SETTING: 15 community pharmacies in the Northern Netherlands.PARTICIPANTS: 157 community-dwelling patients aged ≥65 years who used ≥5 medicines for ≥3 months, including at least one psycholeptic/psychoanaleptic medication and who had a DBI≥1.INTERVENTION: A medication review by the community pharmacist in collaboration with the patient's general practitioner and patient.PRIMARY AND SECONDARY OUTCOMES MEASURES: The primary outcome was the proportion of patients whose DBI decreased by at least 0.5. Secondary outcomes were the presence of anticholinergic/sedative side effects, falls, cognitive function, activities of daily living, quality of life, hospital admission and mortality. Data were collected at baseline and 3 months follow-up.RESULTS: Mean participant age was 75.7 (SD, 6.9) years in the intervention arm and 76.6 (SD, 6.7) years in the control arm, the majority were female (respectively 69.3% and 72.0%). Logistic regression analysis showed no difference in the proportion of patients with a≥0.5 decrease in DBI between intervention arm (17.3%) and control arm (15.9%), (OR 1.04, CI 0.47 to 2.64, p=0.927). Intervention patients scored higher on the Digit Symbol Substitution Test, measure of cognitive function (OR 2.02, CI 1.11 to 3.67, p=0.021) and reported fewer sedative side effects (OR 0.61, CI 0.40 to 0.94, p=0.024) at follow-up. No significant difference was found for other secondary outcomes.CONCLUSIONS: Pharmacist-led medication review as currently performed in the Netherlands was not effective in reducing the anticholinergic/sedative load, measured with the DBI, within the time frame of 3 months. Preventive strategies, signalling a rising load and taking action before chronic use of anticholinergic/sedative medication is established may be more successful.TRIAL REGISTRATION NUMBER: NCT02317666.",
author = "{van der Meer}, {Helene G} and Hans Wouters and Pont, {Lisa G} and Katja Taxis",
note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",
year = "2018",
month = jul,
day = "19",
doi = "10.1136/bmjopen-2017-019042",
language = "English",
volume = "8",
pages = "e019042",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ PUBLISHING GROUP",
number = "7",

}

RIS

TY - JOUR

T1 - Reducing the anticholinergic and sedative load in older patients on polypharmacy by pharmacist-led medication review

T2 - A randomised controlled trial

AU - van der Meer, Helene G

AU - Wouters, Hans

AU - Pont, Lisa G

AU - Taxis, Katja

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/7/19

Y1 - 2018/7/19

N2 - OBJECTIVE: To evaluate if a pharmacist-led medication review is effective at reducing the anticholinergic/sedative load, as measured by the Drug Burden Index (DBI).DESIGN: Randomised controlled single blind trial.SETTING: 15 community pharmacies in the Northern Netherlands.PARTICIPANTS: 157 community-dwelling patients aged ≥65 years who used ≥5 medicines for ≥3 months, including at least one psycholeptic/psychoanaleptic medication and who had a DBI≥1.INTERVENTION: A medication review by the community pharmacist in collaboration with the patient's general practitioner and patient.PRIMARY AND SECONDARY OUTCOMES MEASURES: The primary outcome was the proportion of patients whose DBI decreased by at least 0.5. Secondary outcomes were the presence of anticholinergic/sedative side effects, falls, cognitive function, activities of daily living, quality of life, hospital admission and mortality. Data were collected at baseline and 3 months follow-up.RESULTS: Mean participant age was 75.7 (SD, 6.9) years in the intervention arm and 76.6 (SD, 6.7) years in the control arm, the majority were female (respectively 69.3% and 72.0%). Logistic regression analysis showed no difference in the proportion of patients with a≥0.5 decrease in DBI between intervention arm (17.3%) and control arm (15.9%), (OR 1.04, CI 0.47 to 2.64, p=0.927). Intervention patients scored higher on the Digit Symbol Substitution Test, measure of cognitive function (OR 2.02, CI 1.11 to 3.67, p=0.021) and reported fewer sedative side effects (OR 0.61, CI 0.40 to 0.94, p=0.024) at follow-up. No significant difference was found for other secondary outcomes.CONCLUSIONS: Pharmacist-led medication review as currently performed in the Netherlands was not effective in reducing the anticholinergic/sedative load, measured with the DBI, within the time frame of 3 months. Preventive strategies, signalling a rising load and taking action before chronic use of anticholinergic/sedative medication is established may be more successful.TRIAL REGISTRATION NUMBER: NCT02317666.

AB - OBJECTIVE: To evaluate if a pharmacist-led medication review is effective at reducing the anticholinergic/sedative load, as measured by the Drug Burden Index (DBI).DESIGN: Randomised controlled single blind trial.SETTING: 15 community pharmacies in the Northern Netherlands.PARTICIPANTS: 157 community-dwelling patients aged ≥65 years who used ≥5 medicines for ≥3 months, including at least one psycholeptic/psychoanaleptic medication and who had a DBI≥1.INTERVENTION: A medication review by the community pharmacist in collaboration with the patient's general practitioner and patient.PRIMARY AND SECONDARY OUTCOMES MEASURES: The primary outcome was the proportion of patients whose DBI decreased by at least 0.5. Secondary outcomes were the presence of anticholinergic/sedative side effects, falls, cognitive function, activities of daily living, quality of life, hospital admission and mortality. Data were collected at baseline and 3 months follow-up.RESULTS: Mean participant age was 75.7 (SD, 6.9) years in the intervention arm and 76.6 (SD, 6.7) years in the control arm, the majority were female (respectively 69.3% and 72.0%). Logistic regression analysis showed no difference in the proportion of patients with a≥0.5 decrease in DBI between intervention arm (17.3%) and control arm (15.9%), (OR 1.04, CI 0.47 to 2.64, p=0.927). Intervention patients scored higher on the Digit Symbol Substitution Test, measure of cognitive function (OR 2.02, CI 1.11 to 3.67, p=0.021) and reported fewer sedative side effects (OR 0.61, CI 0.40 to 0.94, p=0.024) at follow-up. No significant difference was found for other secondary outcomes.CONCLUSIONS: Pharmacist-led medication review as currently performed in the Netherlands was not effective in reducing the anticholinergic/sedative load, measured with the DBI, within the time frame of 3 months. Preventive strategies, signalling a rising load and taking action before chronic use of anticholinergic/sedative medication is established may be more successful.TRIAL REGISTRATION NUMBER: NCT02317666.

U2 - 10.1136/bmjopen-2017-019042

DO - 10.1136/bmjopen-2017-019042

M3 - Article

C2 - 30030308

VL - 8

SP - e019042

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 7

ER -

ID: 63400994