Home medication management review in outpatients with alarming health issues in Jordan: a randomized control trial

Objectives Treatment-related problems (TRPs) are of a major concern to healthcare professionals and patients. This led to the emergence of the home medication management review (HMMR) service. The aim of this study was to assess the impact of HMMR service on the number and types of TRPs for outpatients, and the effect of resolving the identified TRPs on the health outcomes of the patients. Methods The HMMR service was delivered by a clinical pharmacist over three months in 2014. Patients with chronic diseases visiting community pharmacies in Jordan were recruited and randomized into intervention and control groups. Patients' data were collected via home visit. TRPs were identified and, for the intervention group only, education was delivered to patients and recommendations were submitted to their physicians. Three months following intervention, all patients were assessed for their TRPs, adherence and self-care activities. Key findings Participants had a mean age of 53.01 10.39. No significant differences (P > 0.05) between the intervention (n = 42) and control groups (n = 42) were found at baseline with regard to demographics, mean number (+/- SD) of TRPs per patient (2.81 +/- 1.70 versus 2.43 +/- 1.50), adherence mean score (1.81 +/- 2.90 versus 2.05 +/- 2.80) and self-care activities mean score (8.62 +/- 4.22 versus 9.48 +/- 6.60). At follow-up, significant differences (P < 0.001) were found with regard to number of TRPs (0.62 +/- 0.85 versus 2.5 +/- 1.50), adherence (0.43 +/- 1.13 versus 2.24 +/- 2.80) and self-care activities (13.9 +/- 3.90 versus 9.38 +/- 6.60). Conclusion Value of the HMMR service has been demonstrated, highlighting the significant role of the community pharmacist in identifying, resolving and preventing TRPs, as well as in improving patients' health outcomes.