ORIGINAL RESEARCH article
Front. Med.
Sec. Family Medicine and Primary Care
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1656595
Effects of a community pharmacy-based structured medication review on drug-related problems in all-comers with polypharmacy: A randomised, controlled, double-blind, parallel-group trial
Provisionally accepted
Thorsten Bischof1*
Alexander Schmidt-Ilsinger2Magdalena Hoppel2Anton Kreuzer3Stefanie Briganser4Philipp Saiko2Susanne Ergott-Badawi2Raimund Podroschko2Stephan Moser5Michael Kossmeier5Bernd Jilma1Stefan Deibl2
Christian Schoergenhofer1*- 1Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
- 2Austrian Chamber of Pharmacists, Vienna, Austria
- 3Humanitas Apotheke, Vienna, Austria
- 4Marco Polo Apotheke, Vienna, Austria
- 5Austrian federation of social insurances, Vienna, Austria
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Background: Medication reviews may help to reduce the burdens of polypharmacy. A medication review type 2a is a structured evaluation of a patient's pharmacotherapy based on medication history and patient information in a face-to-face interview.Methods: This multi-centre, randomised, patient-and assessor-blind, parallel-group trial was conducted in 14 community pharmacies in Vienna, Austria. Adult outpatients taking ≥8 drugs were eligible. The intervention was a medication review type 2a. At baseline, pharmacists assessed drug-related problems (DRP), a parameter summarizing problematic aspects of pharmacotherapy, in all participants. Pharmacists randomised patients (1:1) to the intervention, in which they addressed DRPs, or to the control group, in which DRPs were not addressed. A blind pharmacist reassessed DRPs at the second visit after three-to-four months. The primary endpoint was the difference in the number of DRPs between groups after three-to-four months.Secondary endpoints included changes in therapy adherence, health literacy, and number of active ingredients per patient.Results: Between August 2022 and August 2023, 220 patients (intervention n=110, control n=110) were randomised; 198 completed the primary analysis (intervention n=98, control n=100). A medication review reduced DRPs by ~70% (effect size 0.30, 95% CI: 0.27-0.34) compared to the control group. Therapy adherence-and health literacy-related DRPs decreased significantly by ~60% and ~64%, respectively. Furthermore, a medication review decreased the mean number of active ingredients by ~9% in the intervention group compared to the control group.A medication review type 2a effectively reduced the number of DRPs.
Keywords: medication review, Drug-related problems, Polypharmacy, therapy adherence, Health Literacy, pharmaceutical care, healthcare Trial registration: ISRCTN14052916
Received: 30 Jun 2025; Accepted: 22 Aug 2025.
Copyright: © 2025 Bischof, Schmidt-Ilsinger, Hoppel, Kreuzer, Briganser, Saiko, Ergott-Badawi, Podroschko, Moser, Kossmeier, Jilma, Deibl and Schoergenhofer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Thorsten Bischof, Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
Christian Schoergenhofer, Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.