title: Value of a Community-Based Medication Management Review Service in Jordan: A Prospective Randomized Controlled Study.
abstract: To assess the impact of a medication management review (MMR) service on treatment-related problems (TRPs) and certain clinical outcomes in outpatients.
  
  
  
  Prospective randomized controlled study.
  
  
  
  Two community pharmacies in Amman, Jordan.
  
  
  
  A total of 160 people who visited the two community pharmacies between September 2009 and June 2010.
  
  
  
  Patients were randomized into two groups: intervention (82 patients) and control (78 patients) groups. The clinical pharmacist conducted a baseline assessment MMR for patients in both groups to determine the prevalence and type of TRPs; however, recommendations regarding the identified TRPs were only submitted to the physicians of patients in the intervention group.
  
  
  
  All patients were followed for an average of 3.39 months after their baseline visit to the pharmacy. The impact of the MMR service for the intervention group was assessed by evaluating the outcomes of the recommendations submitted by the clinical pharmacist to resolve the identified TRPs, physicians' acceptance of the recommended interventions, and the effect of the intervention on certain clinical outcomes: blood glucose levels, blood pressure, and triglyceride levels. Follow-up assessment of the control group included evaluating the outcomes of the identified TRPs (identified and corrected by physicians without any input from the clinical pharmacist) and comparing glucose level, blood pressure, and triglyceride-level results with baseline values. No significant differences in mean number of medical conditions (3.7 vs 3.42, p=0.134), mean number of medications (4.51 vs 4.96, p=0.135), or mean number of TRPs per patient (5.55 vs 5.17, p=0.42) were observed at baseline in the intervention group versus the control group. Follow-up results revealed a high acceptance rate of recommendations by the physicians (94%). Regarding outcomes of TRPs, almost 70% of the identified TRPs in the intervention group were resolved or improved compared with 2% in the control group (p<0.001). Significant differences were found between the intervention group versus control group with regard to mean ± SD glucose levels (99.08 ± 9.66 vs 115.48 ± 17.34, p<0.001), blood pressure (110.36/81.55 ± 9.45/3.91 vs 125.0/88.73 ± 10.34/4.12, p<0.001), and triglyceride levels (148.53 ± 15.98 vs 170.74 ± 6.26, p=0.001).
  
  
  
  The MMR service resulted in a significantly lower number of TRPs and significantly improved clinical outcomes, and it was highly accepted by the physicians.
authors: Department of Clinical Pharmacy, Faculty of Pharmacy, Applied Sciences University, Amman, Jordan.
authors: Iman A
authors: IA
authors: Basheti
authors: Department of Biopharmaceutics & Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan.
authors: Odate K I
authors: OK
authors: Tadros
authors: Department of Biopharmaceutics & Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan. aburuz@gmail.com, aburuzs@ksau-hs.edu.sa.|College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. aburuz@gmail.com, aburuzs@ksau-hs.edu.sa.
authors: Salah
authors: S
authors: Aburuz
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D003157:Community Pharmacy Services / Q000458:organization & administration*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007597:Jordan; D008297:Male; D054539:Medication Therapy Management / Q000458:organization & administration*; D008875:Middle Aged; D010045:Outpatients; D010595:Pharmacists / Q000458:organization & administration*; D024382:Professional Role; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D014280:Triglycerides
keywords: Jordan; community pharmacy; medication management review; pharmaceutical care services