Collaborative medication management services: improving patient care

Gilbert, Andrew L.; Roughead, Elizabeth E; Beilby, Justin; Mott, Kathy; Barratt, John D.

doi:10.5694/j.1326-5377.2002.tb04730.x

Cited by 137 publications

(113 citation statements)

References 4 publications

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“…The patient group most likely to experience medication misadventure and therefore most likely to benefit from having a comprehensive medication history documented at the point of admission are the elderly 19. The elderly are also predisposed to adverse drug events as they have physiological differences associated with ageing and often multiple co-morbidities resulting in multiple medications 20.…”

Section: Introductionmentioning

confidence: 99%

“…The elderly are also predisposed to adverse drug events as they have physiological differences associated with ageing and often multiple co-morbidities resulting in multiple medications 20. Patients taking multiple medications and those who have multiple co-morbidities have been associated with a higher incidence of adverse drug events and also medication-related problems 19,21. Also patients who have had a recent hospital admission are considered to be at higher risk 22…”

Section: Introductionmentioning

confidence: 99%

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Eliciting comprehensive medication histories in the emergency department: the role of the pharma

Crook

Ajdukovic

Angley

et al. 2007

Pharmacy pract. (Granada Ed. impr.)

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*The Australian Pharmaceutical Advisory Committee guidelines call for a detailed medication history to be taken at the first point of admission to hospital. Accurate medication histories are vital in optimising health outcomes and have been shown to reduce mortality rates. This study aimed to examine the accuracy of medication histories taken in the Emergency Department of the Royal Adelaide Hospital. Medication histories recorded by medical staff were compared to those elicited by a pharmacy researcher. The study, conducted over a six-week period, included 100 patients over the age of 70, who took five or more regular medications, had three or more clinical co-morbidities and/or had been discharged from hospital in three months prior to the study. Following patient interviews, the researcher contacted the patient's pharmacist and GP for confirmation and completion of the medication history. Out of the 1152 medications recorded as being used by the 100 patients, discrepancies were found for 966 medications (83.9%). There were 563 (48.9%) complete omissions of medications. The most common discrepancies were incomplete or omitted dosage and frequency information. Discrepancies were mostly medications that treated RESUMEN Las guías del Comité Consultivo FarmacéuticoAustraliano piden que se realice un historial de medicación detallado en el punto de ingreso del hospital. Para optimizar los resultados en salud son vitales los historiales de medicación fiables que han demostrado reducir las tasas de mortalidad. Este estudio trató de examinar la fiabilidad de los historiales de medicación tomados en el Servicio de Urgencias del Hospital Real de Adelaida registradas por el personal médicos y se compararon con las extraídas por un investigador de farmacia. El estudio, conducido durante seis semanas, incluyó 100 pacientes de mas de 70 años que tomaban cinco o mas medicamentos habituales, tenían tres o más comorbilidades y/o habían sido dados de alta del hospital en los tres meses anteriores al estudio. Después de las entrevistas a los pacientes, el investigador contactaba al farmacéutico y al médico del paciente para la confirmación y compleción del historial. Del as 1152 medicaciones registradas como utilizadas por los 100 pacientes, se encontraron discrepancias en 966 (83,9%). Hubo 563 (48,9%) omisiones completas de medicación. Las discrepancias más comunes fueron la omisión de dosis y frecuencia. Las discrepancias eran mayoritariamente medicaciones dermatológicas y para problemas de oído, nariz y garganta, pero alrededor del 29% eran usadas para tratar problemas cardiovasculares. Este estudio da apoyo a la presencia de un farmacéutico en un Servicio de Urgencias que pueda compilar un historial de medicación intensivo y fiable para mejorar la gestión del a Original Research

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Eliciting comprehensive medication histories in the emergency department: the role of the pharma

Crook

Ajdukovic

Angley

et al. 2007

Pharmacy pract. (Granada Ed. impr.)

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“…Evidence supports the impact of community pharmacy interventions on consumer health outcomes [8–12]. Randomised and other trials provide proof of the clinical and cost-effectiveness of community pharmacy lipid management interventions in reducing risk factors for coronary heart disease [13, 14].…”

Section: Introductionmentioning

confidence: 99%

‘Making the invisible visible’ through alcohol screening and brief intervention in community pharmacies: an Australian feasibility study

2016

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BackgroundScreening and brief interventions (SBI) for alcohol related problems have been shown to be effective in health settings such as general practice or emergency departments. Recent data from the United Kingdom and New Zealand suggest that SBI can be delivered through community pharmacies, but this approach has not been tested in Australia. This study assesses the feasibility of delivering alcohol SBI via community pharmacists.MethodWe recruited five pharmacies and developed an SBI training package to be delivered by pharmacy staff, who screened consumers and delivered the brief intervention where appropriate. Consumers also completed a questionnaire on the process. At three months consumers were telephoned to enable ‘retention’ to be quantified. After completing recruitment, a semi-structured interview was conducted with pharmacists on the process of delivering the intervention, potential improvements and sustainability.ResultsFifty consumer participants were screened, ten from each pharmacy. There were 28 (57 %) men and 21 (43 %) women with one not responding. Most (67 %) were aged 25–55 years. Their AUDIT scores had a range of 0 to 39 (mean 10.9, SD 9.8) with 11 categorised as ‘hazardous (8–15)’, four as ‘harmful (16–19)’ and eight as ‘probably dependent (20+)’ consumers of alcohol. Reactions to the process of SBI were generally favourable: for example 75 % agreed that it was either appropriate or very appropriate being asked about their alcohol consumption. With respect to follow-up interviews, 23 (46 %) agreed that they could be contacted, including five from the highest AUDIT category. Subsequently 11 (48 %) were contactable at three months. Three of the five non-low risk drinkers had reduced their level of risk over the three months. Ten pharmacists participated in semi-structured telephone interviews. Overall these pharmacists were positive about the intervention and five main themes emerged from the interviews: 1) flexibility applied in recruitment of participants, 2) easiness in use of AUDIT score to facilitate discussions, 3) perceived positive intervention impact, 4) enhanced role of community pharmacists and 5) facilitators and challenges experienced.ConclusionsPharmacy-based SBI appears to be acceptable to consumers and feasible for pharmacy staff to deliver. Challenges remain in translating this potential into actual services.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3805-3) contains supplementary material, which is available to authorized users.

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“…Collaborative medication reviews, undertaken by pharmacists and GPs, have been successful in identifying and resolving medication-related problems, improving quality of prescribing, and optimizing drug use and costs [4,5]. These collaborative services, however, are currently limited and underused due to factors including geographical isolation, limited access to patient medical records, a lack of time for team activities and a health policy that is not conducive to such collaborative arrangements [6].…”

Section: Introductionmentioning

confidence: 99%

An exploration of the role of pharmacists within general practice clinics: the protocol for the pharmacists in practice study (PIPS)

Tan

Stewart

Elliott

et al. 2012

BMC Health Serv Res

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BackgroundMedication-related problems are a serious concern in Australian primary care. Pharmacist interventions have been shown to be effective in identifying and resolving these problems. Collaborative general practitioner-pharmacist services currently available in Australia are limited and underused. Limitations include geographical isolation of pharmacists and lack of communication and access to patient information. Co-location of pharmacists within the general practice clinics is a possible solution. There have been no studies in the Australian setting exploring the role of pharmacists within general practice clinics.The aim of this study is to develop and test a multifaceted practice pharmacist role in primary care practices to improve the quality use of medicines by patients and clinic staff.Methods/designThis is a multi-centre, prospective intervention study with a pre-post design and a qualitative component. A practice pharmacist will be located in each of two clinics and provide short and long patient consultations, drug information services and quality assurance activities. Patients receiving long consultation with a pharmacist will be followed up at 3 and 6 months. Based on sample size calculations, at least 50 patients will be recruited for long patient consultations across both sites. Outcome measures include the number, type and severity of medication-related problems identified and resolved; medication adherence; and patient satisfaction. Brief structured interviews will be conducted with patients participating in the study to evaluate their experiences with the service. Staff collaboration and satisfaction with the service will be assessed.DiscussionThis intervention has the potential to optimise medication use in primary care clinics leading to better health outcomes. This study will provide data about the effectiveness of the proposed model for pharmacist involvement in Australian general practice clinics, that will be useful to guide further research and development in this area.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12612000742875

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Collaborative medication management services: improving patient care

Cited by 137 publications

References 4 publications

Eliciting comprehensive medication histories in the emergency department: the role of the pharma

Eliciting comprehensive medication histories in the emergency department: the role of the pharma

‘Making the invisible visible’ through alcohol screening and brief intervention in community pharmacies: an Australian feasibility study

An exploration of the role of pharmacists within general practice clinics: the protocol for the pharmacists in practice study (PIPS)

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