Health outcomes following provision of Home Medicines Reviews for older people receiving aged care services at home

Janet K Sluggett; Gillian E Caughey; Tracy Air; Catherine Lang; Max Moldovan; Grant Martin; Andrew C Stafford; Stephen R Carter; Shane Jackson; Steve L Wesselingh; Maria C Inacio

doi:10.1016/j.sapharm.2024.08.004

Health outcomes following provision of Home Medicines Reviews for older people receiving aged care services at home

Res Social Adm Pharm. 2024 Nov;20(11):1064-1069. doi: 10.1016/j.sapharm.2024.08.004. Epub 2024 Aug 13.

Authors

Affiliations

¹ University of South Australia, UniSA Allied Health and Human Performance, Adelaide, South Australia, Australia; Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia. Electronic address: janet.sluggett@unisa.edu.au.
² University of South Australia, UniSA Allied Health and Human Performance, Adelaide, South Australia, Australia; Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
³ Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
⁴ Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Biometry Hub, Faculty of Sciences, Engineering and Technology, The University of Adelaide, Waite Campus, Urrbrae, South Australia, Australia.
⁵ Australian Association of Consultant Pharmacy, Fyshwick, Australian Capital Territory, Australia.
⁶ Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
⁷ School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
⁸ School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia.

PMID: 39187425
DOI: 10.1016/j.sapharm.2024.08.004

Abstract

Background: The impact of Home Medicines Reviews (HMRs) on long-term health outcomes among individuals receiving long-term in-home aged care services is unknown.

Objectives: To examine associations between HMR provision and hospitalization, long-term care facility (LTCF) entry and mortality among older people receiving long-term in-home aged care services.

Methods: This retrospective cohort study included individuals aged 65-105 years from three Australian states who accessed in-home aged care services between 2013 and 2017. Using propensity score matching, HMR recipients (n = 1530) were matched to individuals who did not receive an HMR (n = 1530). Associations between HMR provision and outcomes were estimated using multivariable regression models.

Results: Over a median of 414 days (interquartile range 217-650) of follow-up, HMR provision was not associated with hospitalizations for unplanned events (subdistribution hazard ratio (sHR) 1.04, 95%CI 0.96-1.14), falls-related hospitalizations (sHR 0.97, 95%CI 0.83-1.13), LTCF entry (sHR 0.97, 95%CI 0.83-1.13), or all-cause mortality (adjusted HR 0.86, 95%CI 0.72-1.01).

Conclusions: In a cohort of older people receiving long-term in-home aged care services, no differences in unplanned hospitalizations, falls, LTCF entry or mortality were observed those with HMRs compared to those that did not receive an HMR.

Keywords: Aged; Australia; Home care services; Hospitalization; Medication review; Medication therapy management; Mortality; Pharmaceutical services; Pharmacists; Treatment outcome.

MeSH terms

Aged
Aged, 80 and over
Australia
Female
Home Care Services*
Hospitalization* / statistics & numerical data
Humans
Long-Term Care*
Male
Retrospective Studies