An inventory of collaborative medication reviews for older adults-evolution of practices

Background Collaborative medication review (CMR) practices for older adults are evolving in many countries. Development has been under way in Finland for over a decade, but no inventory of evolved practices has been conducted. The aim of this study was to identify and describe CMR practices in Finland after 10 years of developement. Methods An inventory of CMR practices was conducted using a snowballing approach and an open call in the Finnish Medicines Agency's website in 2015. Data were quantitatively analysed using descriptive statistics and qualitatively by inductive thematic content analysis. Clyne et al's medication review typology was applied for evaluating comprehensiveness of the practices. Results In total, 43 practices were identified, of which 22 (51%) were designed for older adults in primary care. The majority (n = 30, 70%) of the practices were clinical CMRs, with 18 (42%) of them being in routine use. A checklist with criteria was used in 19 (44%) of the practices to identify patients with polypharmacy (n = 6), falls (n = 5), and renal dysfunction (n = 5) as the most common criteria for CMR. Patients were involved in 32 (74%) of the practices, mostly as a source of information via interview (n = 27, 63%). A medication care plan was discussed with the patient in 17 practices (40%), and it was established systematically as usual care to all or selected patient groups in 11 (26%) of the practices. All or selected patients' medication lists were reconciled in 15 practices (35%). Nearly half of the practices (n = 19, 44%) lacked explicit methods for following up effects of medication changes. When reported, the effects were followed up as a routine control (n = 9, 21%) or in a follow-up appointment (n = 6, 14%). Conclusions Different MRs in varying settings were available and in routine use, the majority being comprehensive CMRs designed for primary outpatient care and for older adults. Even though practices might benefit from national standardization, flexibility in their customization according to context, medical and patient needs, and available resources is important.Peer reviewe

Internet as a source of medicines information (MI) among frequent internet users

Background: The internet is widely and increasingly used to search for health information. Previous studies have focused mainly on health information on the internet and not specifically on medicines information (MI). Objectives: The aim of this study was to explore the internet as a source of MI compared to other sources of MI; to identify those who use the internet as a source of MI; and to describe patterns of use of the internet as a source of MI. Methods: A cross-sectional design employed a web-based questionnaire posted by patients' and other organizations as well as pharmacies on their websites during six weeks in the beginning of 2014. Logistic regression analysis was used to assess associations of background variables to the use of different MI sources. Results: The most frequently used MI sources among respondents (n = 2489) were package leaflets (90%), pharmacists (83%), physicians (72%), and the internet (68%). According to a multivariate analysis, internet use for MI was associated with female gender, age <65 years, higher education, daily use of the internet, and continuous use of vitamins or herbals. MI was most commonly searched from a Finnish health portal (56%) and websites of pharmacies (41%). Of the respondents, nearly half (43%) used search engines to find information from the internet. The names of the medicinal product, symptom or disease were the most commonly used search terms. Conclusions: Well-educated, young women tend to search MI on the internet. Health care professionals should discuss reliable MI websites and tools that can help patients evaluate the reliability of information.Peer reviewe

Developing a national medicines information strategy in Finland: A stakeholders` perspective on the strengths‚ challenges and opportunities in medicines information

Purpose and setting: The Finnish Medicines Agency was mandated to develop a national medicines information strategy.The objectives of this study were to assess stakeholders’ views on strengths,challenges and opportunities in medicines information for the basis of the strategy. Methods: Interviews among stakeholder representatives (n = 28) from patient organizations, universities, pharmacies,and professional associations in medicine, pharmacy and nursing were conductedin2011. Interviewmemos were thematically content-analysed.The draft strategy was finalized through two public hearings and a public consultation. Results: Stakeholders highlighted the need to increase cooperation and coordination in medicines information.The existence of numerous quality-and evidence-based medicines information sources was identified as astrength; although the stakeholders were con- cerned about the fragmented and unequal access to them.The strengthening of the role of health care professionals in communicating about medicines was seen as an opportunity, but its realization requires improvements in basic and continuing education.Furthermore, the stakeholders emphasized the importance of uniform medicines information regardless of source. Conclusions: Stakeholders identified multiple strengths,challenges and opportunities in medicines information that were fundamental to developing the national medicines infor- mation strategy.An inventory of stakeholder perspectives can be recommended as a tool to support decision-making in pharmaceutical policy

Kuluttajille suunnattu lääkeinformaatio Suomessa: Lääkealan toimijoiden näkemyksiä lääkeinformaation kehittämishaasteista ja mahdollisuuksista

Introduction: The need to improve accessibility and quality of medicines information to consumers has been widely recognized within European Union (EU). The aim of this study was to investigate stakeholders’ perceptions of opportunities and challenges in medicines information to consumers in Finland. Its goal was to inform development of the national medicines information strategy in Finland. Materials and methods: Interviews among 28 key stakeholders (e.g., patient organizations, universities, hospital pharmacies and professional associations) were conducted in 2011. Interviews were complemented with two discussion forums and statements for a draft of the strategy. Inductive thematic content analysis with counting was used to analyze the qualitative data. Results: Increasing collaboration among stakeholders was seen as an opportunity to improve medicines information to consumers. Stakeholders identified many sources of information, however, a need to increase access to reliable and balanced consumer medicines information was reported. The most commonly reported challenges concerned Internet-based medicines information, and especially finding reliable and balanced information. Stakeholders mentioned also challenges in package leaflets (PLs), e.g., difficulties in the readability of the text. Other challenges included the use of social media as a source of medicines information and the need to ensure accessibility of medicines information among ethnic minorities. Furthermore, promoting consumers’ health literacy was highlighted. Conclusions: The main opportunities and challenges in medicines information to consumers are in balancing between Internet-based sources and tailored information targeted to individual patients. This has been taken into account in the Finnish medicines information strategy published in 2012.Johdanto: Tarve parantaa luotettavan kuluttajille suunnatun lääkeinformaation saatavuutta on laajasti tunnistettu niin Euroopan unionissa kuin Suomessakin. Tämän tutkimuksen tavoitteena oli selvittää lääkealan toimijoiden näkemyksiä kuluttajille suunnatun lääkeinformaation mahdollisuuksista ja haasteista. Tutkimus tehtiin kansallisen lääkeinformaatiostrategian pohjaksi. Aineisto ja menetelmät: Tutkimus toteutettiin yksilö- ja ryhmäkeskustelujen (n=28) avulla vuonna 2011. Haastateltuihin toimijoihin sisältyi muun muassa potilasjärjestöjä, yliopistoja, sairaala-apteekkeja sekä lääketieteen, farmasian ja hoitoalan ammattiliittoja. Lääkeinformaatiostrategian luomisen pohjaksi järjestettiin myös kaksi keskustelutilaisuutta ja pyydettiin strategialuonnoksesta lausuntoja sidosryhmiltä. Laadullinen aineisto analysoitiin induktiivisesti teemoittelun ja kvantifioinnin avulla. Tulokset: Sidosryhmät näkivät yhteistyön lisäämisen toimijoiden välillä mahdollisuutena kehittää lääkeinformaatiota. Useita kuluttajille suunnattuja lääkeinformaation lähteitä tunnistettiin, mutta tarve luotettavan ja tasapainoisen kuluttajille suunnatun lääkeinformaation kehittämiseen nostettiin kuitenkin esille. Sidosryhmät kokivat haasteena erityisesti Internetistä löytyvän kuluttajille suunnatun lääkeinformaation luotettavuuden ja totesivat sosiaalisen median keskustelupalstoilla käytävän kokemusperäisen lääketiedon olevan haaste terveydenhuollon ammattilaisille. Myös pakkausselosteiden luettavuuden ja ymmärrettävyyden kehittämistä toivottiin. Erityisryhmille suunnatun lääkeinformaation todettiin olevan puutteellista. Lisäksi kuluttajien terveyden lukutaidon kehittämiselle nähtiin tarve. Johtopäätökset: Merkittävimmät haasteet kuluttajille suunnatun lääkeinformaation kehittämisessä on Internetistä löytyvän tiedon ja yksilöllisesti räätälöidyn tiedon tasapainottamisessa. Tämäkin haaste on huomioitu yhtenä keskeisenä teemana helmikuussa 2012 julkaistussa Suomen ensimmäisessä kansallisessa lääkeinformaatiostrategiassa