Medication Management Services for Dialysis Patients: Impact on Clinical, Economic and Humanistic Outcomes—An Integrative Review

ABSTRACT

Aim

To synthesise evidence on the types of Medication Management Services (MMS) and establish the effect of the different MMS interventions on Economic, Clinical and Humanistic Outcomes (ECHO) in dialysis patients.

Design

Integrative review.

Data Sources

A systematic search was conducted from May to June 2024 using four databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library and Web of Science.

Methods

This review followed Whittemore and Knafl's framework and adhered to the PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Data extraction and quality assessment were independently conducted by three reviewers using the Joanna Briggs Institute Critical Appraisal Tool and the Quality Improvement Minimum Quality Criteria Set. Only English-language articles, primary and quality improvement studies were included, with no restrictions on publication date. Findings were narratively synthesised and thematically grouped by review aims.

Results

A total of 14 articles were included. This review identified (1) the types of MMS provided to renal dialysis patients, and (2) the effects of these services on ECHO. Services varied in practices, including obtaining accurate medication histories, identifying discrepancies, reviewing laboratory results, making recommendations to prescribers, resolving issues based on collaborative agreements and providing patient education. These services were compared in terms of economic outcomes (e.g., 30-day readmission rates), clinical outcomes (e.g., medication discrepancies, MRPs, laboratory and clinical parameters) and humanistic outcomes (e.g., medication burden-related quality of life).

Conclusion

This review highlighted various types of MMS available for dialysis patients and their impact on ECHO. Key benefits include recognising medication discrepancies, reducing MRPs, improving laboratory and clinical parameters, lowering 30-day readmission rates and enhancing medication burden-related quality of life. However, limitations such as retrospective studies, English-only publications and limited comparison across MMS models highlight the need for additional robust and diverse research.

Reporting Method

This integrative review was conducted in accordance with the PRISMA statement.

Patient or Public Contribution

No Patient or Public Contribution.