Medicines Use Review ServiceSLOPUZNCT04417400
Evaluation of Medicines Use Review in Slovenia
A study testing medicines use review in people with Medicines Use Review Service and Multiple Medication, run by Mitja Kos at 14 sites in Slovenia.
Trial summary
Medicines Use Review service (PUZ) has been officially introduced in Slovenian pharmacy practice in 2015 and has been offered to pharmacy customers by pharmacist, certified to provide the service. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Medicines Use Review Service, Multiple Medication, Adherence, Medication
- What is being tested?
- medicines use review
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 169 participants
- Where
- 14 sitesSlovenia
- Study dates
- 9 May 2017to 16 Sep 2017
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- at least one prescription medicine for a chronic condition for at least six months
- deemed to be suitable for MUR by a pharmacist, certified to provide the MUR service;
- ability to communicate in Slovenian; The inclusion of patients was performed in accordance with the SOP MUR, to reflect how patients are generally offered MUR service in Slovenia.
Who cannot join
- urgent need of MUR (the service delay due to randomization would risk their health);
- referred for MUR by a healthcare professional (general practitioner, nurse, etc.);
- the patient's carer, rather than the patient themselves, was able to attend the interviews and receive MUR;
- previously received MUR or an advanced medication review;
- difficulties understanding, communicating or other issues (vision, hearing) that might affect study outcomes.
Trial locations and contacts
14 sites in 1 country.
14 sites in 1 country
Slovenia14 sites
Community pharmacy "Lekarna Brežice"
Brežice, 8250
Community pharmacy "Celjske lekarne javni zavod"
Celje, 3000
Community pharmacy "Kraške lekarne Ilirska Bistrica"
Ilirska Bistrica, 6250
Community pharmacy "Lekarna Kočevje"
Kočevje, 1330
Community pharmacy "Obalne lekarne Koper"
Koper, 6000
Community pharmacy " Gorenjske lekarne"
Kranj, 4000
Community pharmacy "Lekarna Ljubljana"
Ljubljana, 1000
Community pharmacy "Javni zdravstveni zavod Mariborske lekarne Maribor"
Maribor, 2000
Community pharmacy "Pomurske lekarne Murska Sobota"
Murska Sobota, 9000
Community pharmacy "Goriška lekarna Nova Gorica"
Nova Gorica, 5000
Community pharmacy "Lekarna Ormož"
Ormoz, 2270
Community pharmacy "Lekarne Ptuj"
Ptuj, 2250
Community pharmacy "Lekarna Sevnica"
Sevnica, 8290
Community pharmacy "Žalske lekarne Žalec"
Žalec, 3310
About this study
Official title: Benefits of Medicines Use Review Service in Slovenia: a Randomized Controlled Trial
Medicines Use Review service (PUZ) has been officially introduced in Slovenian pharmacy practice in 2015 and has been offered to pharmacy customers by pharmacist, certified to provide the service. Patients can to talk to a pharmacist and discuss their medicines, how they use it and any issues or question they might have. We designed a study to evaluate how Medicines Use Review (PUZ) work and how it is reaching the set objectives. The objectives of the PUZ service are to address actual patient medicines use and consequently improve medication adherence, identify and solve drug related problems and enhance medication knowledge. Pharmacists, who are certified to provide the service, recognized the patients, who might need the service and invited them to participate in the study. The study consisted of two visits in 12 weeks' time period. Patients, who decided to participate, were randomly allocated in two groups - intervention and control. Both groups were interviewed and fulfilled questionnaires at visit 1 (V1). Afterwards the test group patients received PUZ. After 12 weeks both groups attended the visit 2 (V2), where they were re-interviewed and fulfilled questionnaires again. After the study completion also the patients from control group received PUZ due to ethical reasons.
- Being tested
- medicines use review
- Keywords
- adherence, medicines use review, drug related problems, cognitive pharmaceutical service, community pharmacy
- Medical subject headings
- Medication Adherence
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
medicines use reviewBehavioural
The provision of MUR service as defined in the SOP MUR (Slovene Chamber of Pharmacies). It is classified as a type 2a review (PCNE typology) and it is intended for the patients to support them in regular and proper medicines use. MUR is performed based on medication history and information provided by the patient in a purposely scheduled conversation with the pharmacist. Pharmacists must be certified to provide MUR. MUR goal is to identify DRPs and recommend interventions to resolve them. During the MUR interview, the pharmacist completes a working sheet that records information regarding medicines, identified DRPs and recommended interventions. After the MUR interview, patients are provided with a personal medicines card that contains all the information that is needed to support effective and safe medicines use (dosing regimen, taking with/without food, special warnings, recommendations, etc.).
| Study group | Role | What they receive |
|---|---|---|
| Intervention | Experimental | Patients who received MUR at visit 1 Receives: Behavioral: medicines use review |
| Control | No intervention | Patients received standard care and MUR after visit 2 (upon completion of the study) |
What is being measured
The primary outcome is the main question the study is designed to answer.
medication adherence
Self-reported medication adherence to multiple medications, evaluated by an 8-item Morisky Medication Adherence Scale (©MMAS-8) and scored with ©Morisky Widget MMAS-8 Software. MUR impact was defined as the relative difference in in MMAS-8 score after 12 weeks (V2-V1) between test and control group.
Measured: 12 weeks (V2-V1)
Secondary outcomes (3)
drug-related problems
The changes in the proportion of manifested DRPs, the proportion of patients with at least one mDRPs, and the risk of the mDRPs between visits. This outcome only considered for the intervention group (test group), therefore the before-after analysis was applied.
Measured: 12 weeks (V2-V1)
Medicine-associated burden
MUR impact on medicine-associated burden was defined as the mean relative difference in the score of Living with Medicines Questionnaire (©LMQ), visual analog scale (VAS) and each domain score between test and control group after 12 weeks (V1-V2).
Measured: 12 weeks (V1-V2)
Patient information ('knowledge') regarding medicines
Interview with the patients. Patients answered three questions regarding each of their regularly used prescription medicines: (i) "What are you taking the medicine for?", to state the purpose of medicine use; (ii) "How are you supposed to take the medicine?", to state the daily dose; and (iii) "Do you know of any special warnings regarding the medicine? If yes, which ones?". Accuracy of answers regarding the purpose of medicine and its daily dose were checked by comparing them with either physician instructions or, when physician instructions were unavailable, Summary of Product Characteristics (SmPC). Answers were deemed to be 'correct' if they matched the information in these sources, 'incorrect' if they did not match or 'not known' if patients responded with "I don't know" or 'no'. Proportions of correct and incorrect answers per patient-medicine, and proportions of improvement or deterioration in given information between visits for the test and control group, were assessed.
Measured: 12 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Jun 2020
- Study start9 May 2017
- Primary completion16 Sep 2017
- Study completion16 Sep 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Medicines Use Review ServiceStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Upon enrollment patients were centrally randomized into two groups -test and control. Patients from the test group received MUR at visit 1. After 12 weeks both groups were reinterviewed. Upon study completion, patients from the control group received MUR due to ethical reasons, however the documentation was not part of the study anymore.
- Masking
- None (open label)
- Enrolment
- 169 participants (actual)
Sponsor and investigators
- Lead sponsor
- Mitja Kos
- Sponsor type
- University, hospital or other
- Collaborators
- Comunity pharmacy Celjske lekarne, Comunity pharmacy Gorenjske lekarne, Comunity pharmacy Goriška lekarna Nova Gorica, Comunity pharmacy Javni zdravstveni zavod Mariborske lekarne Maribor, Comunity pharmacy Kraške lekarne Ilirska Bistrica, Comunity pharmacy Lekarna Brežice, Comunity pharmacy Lekarna Kočevje, Comunity pharmacy Lekarna Ljubljana, Comunity pharmacy Lekarna Ormož, Comunity pharmacy Lekarna Sevnica, Comunity pharmacy Lekarne Ptuj, Comunity pharmacy Obalne lekarne Koper, Comunity pharmacy Pomurske lekarne Murska Sobota, Comunity pharmacy Žalske lekarne Žalec
- Responsible party
- Sponsor-investigator, Mitja Kos, University of Ljubljana
- Investigators
- Igor Locatelli, M.Pharm, PhD, Study director, University of LjubljanaMitja Kos, MPharm, PhD, Principal investigator, University of LjubljanaUrska Nabergoj Makovec, MPharm, Study chair, University of Ljubljana
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04417400
- Sponsor's protocol ID
- MZ 0120-321/2016-2
- Other IDs
- P1-0189
- Acronym
- SLOPUZ
- Status last verified
- Jun 2020
- First submitted
- 1 Jun 2020
- Last updated
- 4 Jun 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: We plan to publish the results of the study in a form of original research manuscript in an international journal with the impact factor. Any questions regarding the study protocol, process and analysis can be address to the principal investigator.
Publications
Nabergoj Makovec U, Kos M, Pisk N. Community pharmacists' perspectives on implementation of Medicines Use Review in Slovenia. Int J Clin Pharm. 2018 Oct;40(5):1180-1188. doi: 10.1007/s11096-018-0644-6. Epub 2018 Jun 16.
PubMed 29909563Griese-Mammen N, Hersberger KE, Messerli M, Leikola S, Horvat N, van Mil JWF, Kos M. PCNE definition of medication review: reaching agreement. Int J Clin Pharm. 2018 Oct;40(5):1199-1208. doi: 10.1007/s11096-018-0696-7. Epub 2018 Aug 2.
PubMed 30073611Nabergoj Makovec U, Locatelli I, Kos M. Improved adherence with Medicines Use Review service in Slovenia: a randomized controlled trial. BMC Health Serv Res. 2021 Mar 22;21(1):266. doi: 10.1186/s12913-021-06223-8.
PubMed 33752647
Study at a glance
From the registry record, last updated by the sponsor on 4 Jun 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Benefits of Medicines Use Review Service in Slovenia: a Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT04417400
- Acronym / sponsor ID
- SLOPUZ / MZ 0120-321/2016-2
- Keywords
- adherence, medicines use review, drug related problems, cognitive pharmaceutical service, community pharmacy
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 169 participants (actual)
- Lead sponsor
- Mitja KosUniversity, hospital or other
- Collaborators
- Comunity pharmacy Celjske lekarne, Comunity pharmacy Gorenjske lekarne, Comunity pharmacy Goriška lekarna Nova Gorica, Comunity pharmacy Javni zdravstveni zavod Mariborske lekarne Maribor, Comunity pharmacy Kraške lekarne Ilirska Bistrica, Comunity pharmacy Lekarna Brežice, Comunity pharmacy Lekarna Kočevje, Comunity pharmacy Lekarna Ljubljana, Comunity pharmacy Lekarna Ormož, Comunity pharmacy Lekarna Sevnica, Comunity pharmacy Lekarne Ptuj, Comunity pharmacy Obalne lekarne Koper, Comunity pharmacy Pomurske lekarne Murska Sobota, Comunity pharmacy Žalske lekarne Žalec
- Study start
- 9 May 2017 (actual)
- Primary completion
- 16 Sep 2017 (actual)
- Study completion
- 16 Sep 2017 (actual)
- First posted
- 4 Jun 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Medicines Use Review service (PUZ) has been officially introduced in Slovenian pharmacy practice in 2015 and has been offered to pharmacy customers by pharmacist, certified to provide the service. Patients can to talk to a pharmacist and discuss their medicines, how they use it and any issues or question they might have. We designed a study to evaluate how Medicines Use Review (PUZ) work and how it is reaching the set objectives. The objectives of the PUZ service are to address actual patient medicines use and consequently improve medication adherence, identify and solve drug related problems and enhance medication knowledge. Pharmacists, who are certified to provide the service, recognized the patients, who might need the service and invited them to participate in the study. The study consisted of two visits in 12 weeks' time period. Patients, who decided to participate, were randomly allocated in two groups - intervention and control. Both groups were interviewed and fulfilled questionnaires at visit 1 (V1). Afterwards the test group patients received PUZ. After 12 weeks both groups attended the visit 2 (V2), where they were re-interviewed and fulfilled questionnaires again. After the study completion also the patients from control group received PUZ due to ethical reasons.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- Upon enrollment patients were centrally randomized into two groups -test and control. Patients from the test group received MUR at visit 1. After 12 weeks both groups were reinterviewed. Upon study completion, patients from the control group received MUR due to ethical reasons, however the documentation was not part of the study anymore.
| Arm | Type | Receives |
|---|---|---|
| Intervention | Experimental | Behavioral: medicines use reviewPatients who received MUR at visit 1 |
| Control | No intervention | –Patients received standard care and MUR after visit 2 (upon completion of the study) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- at least one prescription medicine for a chronic condition for at least six months
- deemed to be suitable for MUR by a pharmacist, certified to provide the MUR service;
- ability to communicate in Slovenian; The inclusion of patients was performed in accordance with the SOP MUR, to reflect how patients are generally offered MUR service in Slovenia.
Key exclusion criteria (5 listed)
- urgent need of MUR (the service delay due to randomization would risk their health);
- referred for MUR by a healthcare professional (general practitioner, nurse, etc.);
- the patient's carer, rather than the patient themselves, was able to attend the interviews and receive MUR;
- previously received MUR or an advanced medication review;
- difficulties understanding, communicating or other issues (vision, hearing) that might affect study outcomes.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| medicines use reviewThe provision of MUR service as defined in the SOP MUR (Slovene Chamber of Pharmacies). It is classified as a type 2a review (PCNE typology) and it is intended for the patients to support them in regular and proper medicines use. MUR is performed based on medication history and information provided by the patient in a purposely scheduled conversation with the pharmacist. Pharmacists must be certified to provide MUR. MUR goal is to identify DRPs and recommend interventions to resolve them. During the MUR interview, the pharmacist completes a working sheet that records information regarding medicines, identified DRPs and recommended interventions. After the MUR interview, patients are provided with a personal medicines card that contains all the information that is needed to support effective and safe medicines use (dosing regimen, taking with/without food, special warnings, recommendations, etc.). | Behavioural | Intervention |
Primary outcome
medication adherence
Time frame: 12 weeks (V2-V1)
Self-reported medication adherence to multiple medications, evaluated by an 8-item Morisky Medication Adherence Scale (©MMAS-8) and scored with ©Morisky Widget MMAS-8 Software. MUR impact was defined as the relative difference in in MMAS-8 score after 12 weeks (V2-V1) between test and control group.
3 secondary outcomes
drug-related problems
Time frame: 12 weeks (V2-V1)
Medicine-associated burden
Time frame: 12 weeks (V1-V2)
Patient information ('knowledge') regarding medicines
Time frame: 12 weeks
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Jun 2020.
- Background: PubMed 29909563Nabergoj Makovec U, Kos M, Pisk N. Community pharmacists' perspectives on implementation of Medicines Use Review in Slovenia. Int J Clin Pharm. 2018 Oct;40(5):1180-1188. doi: 10.1007/s11096-018-0644-6. Epub 2018 Jun 16.
- Background: PubMed 30073611Griese-Mammen N, Hersberger KE, Messerli M, Leikola S, Horvat N, van Mil JWF, Kos M. PCNE definition of medication review: reaching agreement. Int J Clin Pharm. 2018 Oct;40(5):1199-1208. doi: 10.1007/s11096-018-0696-7. Epub 2018 Aug 2.
- Derived from this study: PubMed 33752647Nabergoj Makovec U, Locatelli I, Kos M. Improved adherence with Medicines Use Review service in Slovenia: a randomized controlled trial. BMC Health Serv Res. 2021 Mar 22;21(1):266. doi: 10.1186/s12913-021-06223-8.
- Individual participant dataSharing planned: No. We plan to publish the results of the study in a form of original research manuscript in an international journal with the impact factor. Any questions regarding the study protocol, process and analysis can be address to the principal investigator.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Igor Locatelli, M.Pharm, PhD study director
University of Ljubljana
Mitja Kos, MPharm, PhD principal investigator
University of Ljubljana
Urska Nabergoj Makovec, MPharm study chair
University of Ljubljana
14 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing medicines use review in people with Medicines Use Review Service and Multiple Medication, run by Mitja Kos at 14 sites in Slovenia.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Jun 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 14 sites in Slovenia. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
medication adherence (time frame: 12 weeks (V2-V1)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04417400, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Jun 2020.