Impact of pharmacist-led medication therapy management in ambulatory elderly patients with chronic diseases

Br J Clin Pharmacol. 2021 Jul;87(7):2937-2944. doi: 10.1111/bcp.14709. Epub 2021 Jan 20.


Aims: This study aimed to assess the impact of pharmacist-led medication therapy management (MTM) performed on ambulatory elderly patients with chronic diseases.

Methods: Patients who came to a pharmacist-led outpatient clinic between January 2016 and June 2018 were enrolled in this study. Eligible subjects received MTM services from the pharmacists at least twice a year and the clinical data of these patients were complete. Drug-related problems (DRPs) and recommendations were evaluated using The Pharmaceutical Care Network Europe Classification for Drug related problems V8.03.

Results: A total of 525 DRPs were identified during the study period. Treatment effectiveness (53.71%) was the most common DRP. The most frequently recommended intervention was changing the drug (48.76%). There were 92.38% patients accepting the interventions and 90.48% patients completely implemented. The number of drugs taken was the significant associated factor for DRPs. Postintervention data collection showed lower levels in systolic blood pressure (BP) and diastolic BP compared to the preintervention data collection. There were statistically significant changes in total cholesterol, low-density lipoprotein cholesterol and triglycerides between the pre- and postintervention data collections. The average cost of medications per patient for every month decreased from 387.72 to 355.17 renminbi (P = .009).

Conclusion: We confirmed that pharmacists had a valuable role to perform MTM services for ambulatory elderly patients, not only in identifying and solving the DRPs, but also in improving clinical outcomes (BP and lipid level) and cost-saving effect.

Keywords: China; ambulatory patient; drug-related problems; medication therapy management; pharmacist.

MeSH terms

  • Aged
  • Ambulatory Care Facilities
  • Chronic Disease
  • Humans
  • Medication Therapy Management
  • Pharmaceutical Services*
  • Pharmacists*