Preliminary feasibility assessment of a targeted, pharmacist-led intervention for older adults with polypharmacy: a mixed-methods study

Lisheng Liu; Bernadette Brokenshire; Deborah Davies; Jeff Harrison

doi:10.1007/s11096-024-01740-y

Preliminary feasibility assessment of a targeted, pharmacist-led intervention for older adults with polypharmacy: a mixed-methods study

Int J Clin Pharm. 2024 May 16. doi: 10.1007/s11096-024-01740-y. Online ahead of print.

Authors

Lisheng Liu^{1

2}, Bernadette Brokenshire², Deborah Davies², Jeff Harrison³

Affiliations

¹ School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand.
² Primary, Public and Community Health, Te Whatu Ora MidCentral District, Palmerston North, New Zealand.
³ School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand. jeff.harrison@auckland.ac.nz.

PMID: 38753077
DOI: 10.1007/s11096-024-01740-y

Abstract

Background: Polypharmacy is associated with the prescription of inappropriate medications and avoidable medication-related harm. A novel pharmacist-led intervention aims to identify and resolve inappropriate medication prescriptions in older adults with polypharmacy.

Aim: To conduct a preliminary feasibility assessment of the intervention in primary care, testing whether specific components of the intervention procedures and processes can be executed as intended.

Method: The mixed-methods study was approved by the New Zealand Health and Disability Ethics Committees and public health agency. Patients from a New Zealand general practice clinic were recruited over 4 weeks to receive the intervention. The preliminary feasibility assessment included measures of intervention delivery, patient-reported outcome measures, and perspectives from ten patients and six clinicians. Data were analysed quantitatively and qualitatively to determine if a full-scale intervention trial is warranted. The study's progression criteria were based on established research and guided the decision-making process.

Results: The intervention met the study's progression criteria, including patient recruitment, retention, and adherence to the intervention procedures. However, several modifications were identified, including: (1) enhancing patient recruitment, (2) conducting a preliminary meeting between the patient and pharmacist, (3) supporting pharmacists in maintaining a patient-centred approach, (4) reviewing the choice of patient-reported outcome measure, (5) extending the 8-week follow-up period, (6) allocating more time for pharmacists to conduct the intervention.

Conclusion: The study found the intervention feasible; however, additional development is required before progressing to a full-scale trial. This intervention has the potential to effectively reduce medication-related harm and improve outcomes for older adults with polypharmacy.

Trial registration number: ACTRN12621000268842 Date registered: 11/03/2021.

Keywords: Aged; Feasibility studies; Geriatrics; Inappropriate prescribing; Pharmacists; Polypharmacy.