Impact of pharmacist-led shared medication reviews on adherence among polymedicated older patients: an observational retrospective French study.

BACKGROUND: Inappropriate medication use or suboptimal medication adherence among polymedicated older patients is a public health concern. To tackle this issue, a pharmacist-led shared medication review (SMR) system was implemented in French community pharmacies in March 2018. SMR is an analysis of the drug treatments of the older patient with multiple medications. SMR takes place in the form of several interviews, at the pharmacy with the pharmacist, in a confidential space. OBJECTIVES: This observational real-world study evaluated the impact of the SMR service on medication adherence among polymedicated older patients in France. The risk of drug-related iatrogenic events in this population and the extent to which pharmacist SMR recommendations were followed by prescribers were also assessed. METHODS: Data were collected using the Observia webtool made by Observia society, a purpose-built digital platform distributed nationwide to community pharmacies to facilitate the SMR process. RESULTS: Data were analyzed from 439 patients (aged 65-75 years or older) who had completed their SMR at one of 297 French community pharmacies equipped with the Observia webtool. Overall, 186 patients had suboptimal adherence before SMR; 47% of these patients (n = 88) improved to have good adherence after completing the review. The rate of SMR-recommended prescription changes implemented by prescribers was low (14.7%; 38 of 258), with changes being implemented precisely as recommended in 47.4% of cases (n = 18). Potential iatrogenic events were identified in 20 patients. CONCLUSIONS: Although the SMR service is in the early stages of implementation in France, this study revealed that the process had a positive impact on medication adherence among older polymedicated patients. However, improvements are needed to reinforce prescriber and patient confidence in the system and further improve health outcomes.

Impact of personalized text messages from pharmacists on medication adherence in type 2 diabetes in France: A real-world, randomized, comparative study.

OBJECTIVE: A real-world, randomized study assessing the impact of a new, personalized, pharmacist-led text messaging service for managing type 2 diabetes (T2D). METHODS: Messages were tailored to patient's needs based on their disease management habits, propensity for reactance, and physical activity levels at baseline. Treatment adherence (assed using the Morisky Medication Adherence Scale, MMAS-8, questionnaire), clinical factors (body mass index and physical activity) and biological markers for T2D were compared between patients who received a text message daily for 3 months in addition to standard care (SMS group) and those who received standard care alone (control group). RESULTS: 114 pharmacies recruited 499 patients. Greater increases in global MMAS-8 scores were observed after 3 months for the SMS group than for the control group, however, this improvement was not sustained after the text messages stopped. Body mass index was found to improve with the text messaging service. CONCLUSION: This study indicated that personalized text messages provided by community pharmacists can have an impact on adherence levels among T2D patients. PRACTICE IMPLICATIONS: Pharmacy-led innovations, such as text messaging services, could be used to accompany patients in their treatment and to improve patient understanding of their illness between healthcare appointments.