Clinical Research Directory

Factors Determining the Rate of Adoption of Pharmaceutical Recommendations by Patients in Primary Care Following a Medication Review by a Pharmacist

Polypharmacy is a growing public health concern associated with adverse drug events, drug interactions, and hospitalizations. Medication reviews (MedRev) are structured evaluations of patients' medications aiming to optimize treatment and improve outcomes. In Belgium, a reimbursed MedRev service involving community pharmacists and general practitioners (GPs) has been implemented since 2023. The RevMedAdopt Pharmacy Study is a national prospective interventional study evaluating the real-world implementation of pharmaceutical recommendations generated during medication reviews performed by supervised final-year pharmacy students. The primary objective is to assess the adoption rate of pharmaceutical recommendations at 3 and 6 months after the medication review. Recommendations are categorized as fully adopted, partially adopted, not adopted, or unavailable. Secondary objectives are to identify factors associated with recommendation implementation, including patient characteristics, pharmacist and GP collaboration, medication review processes, and recommendation-related factors. The study includes adult polymedicated patients living at home in Belgium and followed by both a GP and a reference pharmacist. Approximately 120 patients will be recruited. Medication reviews are conducted during pharmacy internships following the official Belgian MedRev framework. Recommendations validated by supervising pharmacists are communicated to GPs. Follow-up data are collected through telephone interviews with patients and GPs. Qualitative interviews with patients, pharmacists, and GPs explore barriers and facilitators influencing recommendation adoption. This mixed-methods study aims to improve understanding of the implementation of pharmacist-led medication review recommendations in primary care and to support optimization of interprofessional collaboration and medication review services.