The Effectiveness of Collaborative Medicine Reviews in Delaying Time to Next Hospitalization for Patients With Heart Failure in the Practice Setting: Results of a Cohort Study
Open accessAbstract
Background— Randomized controlled trials have demonstrated that collaborative medication reviews can improve outcomes for patients with heart failure. We aimed to determine whether these results translated into Australian practice, where collaborative reviews are nationally funded. Methods and Results— This retrospective cohort study using administrative claims data included veterans 65 years and older receiving bisoprolol, carvedilol, or metoprolol succinate for which prescribing physicians indicated treatment was for heart failure. We compared those exposed to a general practitioner–pharmacist collaborative home medication review with those who did not receive the service. The service includes physician referral, a home visit by an accredited pharmacist to identify medication-related problems, and a pharmacist report with follow-up undertaken by the physician. Kaplan-Meier analyses and Cox proportional hazards models were used to compare time until next hospitalization for heart failure between the exposed and unexposed groups. There were 273 veterans exposed to a home medicines review and 5444 unexposed patients. Average age in both groups was 81.6 years (no significant difference). The median number of comorbidities was 8 in the exposed group and 7 in the unexposed ( P <0.0001). Unadjusted results showed a 37% reduction in rate of hospitalization for heart failure at any time (hazard ratio, 0.63; 95% CI, 0.44 to 0.89). Adjusted results showed a 45% reduction (hazard ratio, 0.55; 95% CI, 0.39 to 0.77) among those who had received a home medicines review compared with the unexposed patients. Conclusion— Medicines review in the practice setting is effective in delaying time to next hospitalization for heart failure in those treated with heart failure medicines.
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Research evaluating the impact of collaborative medication reviews indicates that such services improve prescribing, and have the potential to reduce health service use and medication costs for patients with multiple chronic conditions.
“Research evaluating the impact of collaborative medication reviews indicates that such services improve prescribing, and have the potential to reduce health service use and medication costs for patients with multiple chronic conditions [18,19].”
From From “retailers” to health care providers: Transforming the role of community pharmacists in chronic disease management (2015) · cites this paper as [19]
The Discussion reports that collaborative home medication reviews were associated with a 45% lower rate of heart-failure hospitalization in the study population, supporting the potential to reduce health-service use. The paper describes identifying medication-related problems, but does not report improved prescribing or reduced medication costs. Its findings concern older patients with heart failure, not patients with multiple chronic conditions generally. (LLM, conf=0.88)
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Home Medicines Reviews: Extent of Uptake by High‐Risk Veterans
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The Impact of Pharmacist-Based Services Across the Spectrum of Outpatient Heart Failure Therapy
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The role of community pharmacy in post hospital management of patients initiated on warfarin
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An Elective Course in Differential Diagnostics
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- Authors
- Roughead, E. E., Barratt, J. D., Ramsay, E., Pratt, N., Ryan, P., Peck, R., Killer, G., & Gilbert, A. L.
- Affiliations
- University of South Australia (AU)
- Venue
- Circulation: Heart Failure
- Published
- 2009-09
- Volume
- 2
- Issue
- 5
- Pages
- 424-428
- ISSN
- 1941-3289 (ISSN-L)
- 1941-3297
- OpenAlex
- W2108369890
- Cited by
- 129
- References
- 16
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2022: 3 · 2021: 3 · 2020: 7 · 2019: 10 · 2018: 10 · 2017: 4 · 2016: 12 · 2015: 9 · 2014: 9 · 2013: 8 · 2012: 18
- FWCI
- 10.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- heart failure, home medicines review, pharmacist intervention, heart failure hospitalization, veterans, older adults, beta-blockers, bisoprolol, carvedilol, metoprolol succinate, drug-related problems, real-world effectiveness
- MeSH terms
- Carvedilol, Adrenergic beta-Antagonists, Aged, Aged, 80 and over, Australia, Carbazoles, Community Pharmacy Services, Cooperative Behavior, Family Practice, Female, Heart Failure, Hospitalization, House Calls, Humans, Male, Metoprolol, Propanolamines, Referral and Consultation, Retrospective Studies, Time Factors, Veterans, Program Evaluation, Proportional Hazards Models, Treatment Outcome, Bisoprolol, Widowhood, Risk Assessment, Databases as Topic, Kaplan-Meier Estimate
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