Paying pharmacists for patient care

Houle, Sherilyn K.D.; Grindrod, Kelly; Chatterley, Trish; Tsuyuki, Ross T.

doi:10.1177/1715163514536678

Cited by 128 publications

(47 citation statements)

References 46 publications

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“…Since July 2012, Alberta pharmacists have been able to claim a fee from the Alberta government for medication management services. 25 Pharmacists enrolling patients into the study before this date would therefore have received remuneration for providing care for study patients that otherwise would not have been offered. Conversely, after July 2012, this fee discrepancy would have been reduced because fee-for-service remuneration would have been available for these patients outside the study environment.…”

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confidence: 99%

Randomized Trial of the Effect of Pharmacist Prescribing on Improving Blood Pressure in the Community

et al. 2015

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Background-Hypertension control rates remain suboptimal. Pharmacists' scope of practice is evolving, and their position in the community may be ideal for improving hypertension care. We aimed to study the impact of pharmacist prescribing on blood pressure (BP) control in community-dwelling patients. Methods and Results-We designed a patient-level, randomized, controlled trial, enrolling adults with above-target BP (as defined by Canadian guidelines) through community pharmacies, hospitals, or primary care teams in 23 communities in Alberta. Intervention group patients received an assessment of BP and cardiovascular risk, education on hypertension, prescribing of antihypertensive medications, laboratory monitoring, and monthly follow-up visits for 6 months (all by their pharmacist). Control group patients received a wallet card for BP recording, written hypertension information, and usual care from their pharmacist and physician. Primary outcome was the change in systolic BP at 6 months. A total of 248 patients (mean age, 64 years; 49% male) were enrolled. Baseline mean±SD systolic/diastolic BP was 150±14/84±11 mm Hg. The intervention group had a mean±SE reduction in systolic BP at 6 months of 18.3±1.2 compared with 11.8±1.9 mm Hg in the control group, an adjusted difference of 6.6±1.9 mm Hg (P=0.0006). The adjusted odds of patients achieving BP targets was 2.32 (95% confidence interval, 1.17-4.15 in favor of the intervention). Conclusions-Pharmacist

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confidence: 99%

Randomized Trial of the Effect of Pharmacist Prescribing on Improving Blood Pressure in the Community

et al. 2015

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“…1 a key aspect of this evolution is movement beyond traditional roles in medicines supply towards increasing provision of 'cognitive pharmacy services' (ie services that specifically draw on pharmacists' specialised knowledge to promote safe, effective use of medicines). 2 in practical terms, this means new roles for pharmacists within community pharmacies, [3][4][5][6] as well as new models of care that facilitate pharmacist contributions in other parts of PHC.…”

Section: Introductionmentioning

confidence: 99%

“…18 The 'residential medication management review' was introduced in 2005 and adherence support services in 2012. 1,19 Pharmacist contribution outside the traditional realm of community pharmacy has also evolved with changing models of care in PHC internationally. 7 Pharmacists have been employed in population-level primary care management organisations 8 similar to New Zealand (NZ) Primary Health Organisations (PHOs) and, more recently, the concept is emerging of pharmacists being fully integrated within general practice teams.…”

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confidence: 99%

Beyond the four walls: an exploratory survey of location, employment and roles of pharmacists in primary health care

2017

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INTRODUCTION:Recognition of the need to reduce harm and optimise patient outcomes from the use of medicines is contributing to an evolution of pharmacy practice in primary health care internationally. This evolution is changing community pharmacy and leading to new models of care that enable pharmacist contribution beyond traditional realms. There is little information about the extent of these changes in New Zealand. AIM:The aim of this study was to investigate emerging roles of pharmacists in primary health care. METHODS:A 10-question electronic survey was used to collect quantitative data about location, employment and roles of pharmacists practising in primary health care.RESULTS: There were 467 survey responses. Although most pharmacists are employed by (78%, n = 357/458) and located in (84%, n = 393/467) community pharmacies, small numbers are dispersed widely across the primary health care sector. Of the 7% (n = 31/467) working in general practices, most are employed by Primary Health Organisations or District Health Boards. Limited cognitive pharmacy service provision is evident in the sector overall, but is much greater for pharmacists spending time located within general practices. DISCUSSION:The large proportion of pharmacists practising in community pharmacies emphasises the importance of the Community Pharmacy Services Agreement in facilitating increased cognitive pharmacy service provision to optimise patient outcomes. The small numbers of pharmacists located elsewhere in the primary health care sector suggest there is scope to improve collaboration and integration in these areas. Flexible funding models that promote innovation and support sustainable practice change are key.

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“…Across the programs implemented so far, substantial variation is observed in referral mechanisms, eligibility criteria, pharmacist training, reimbursement schemes, and frequency, content and location of the reviews [5, 9]. In the United Kingdom (UK) medication reviews have been classified into three types: prescription review (a review of patients’ prescription or medication records); compliance or concordance review (explores patients’ medication-taking practices, knowledge and beliefs); and clinical medication review (conducted with access to patients’ medical record and with the patient present) [7].…”

Section: Introductionmentioning

confidence: 99%

“…In 2007, the Ontario Ministry of Health and Long-Term Care (MOHLTC) launched MedsCheck (MC), the first government-funded, community pharmacy-led medication review program in Canada [5]. The stated purpose of the MC service is to help patients better understand their medication therapy and ensure that medications are taken as prescribed (MC Program Guidebook 2008) [10].…”

Section: Introductionmentioning

confidence: 99%

Factors affecting the delivery of community pharmacist-led medication reviews: evidence from the MedsCheck annual service in Ontario

Pechlivanoglou

Abrahamyan

MacKeigan

et al. 2016

BMC Health Serv Res

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BackgroundMedication reviews have become part of pharmacy practice across developed countries. This study aimed to identify factors affecting the likelihood of eligible Ontario seniors receiving a pharmacy-led medication review called MedsCheck annual (MCA).MethodsWe designed a cohort study using a random sample of pharmacy claims for MCA-eligible Ontario seniors using linked administrative data from April 2012 to March 2013. Guided by a conceptual framework, we constructed a generalized-estimating-equations model to estimate the effect of patient, pharmacy and community factors on the likelihood of receiving MCA.ResultsOf the 2,878,958 eligible claim-dates, 65,605 included an MCA. Compared to eligible individuals who did not receive an MCA, recipients were more likely to have a prior MCA (OR = 3.03), receive a new medication on the claim-date (OR = 1.78), be hypertensive (OR = 1.18) or have a recent hospitalization (OR = 1.07). MCA recipients had fewer medications (e.g., OR = 0.44 for ≥12 medications versus 0–4 medications), and were less likely to receive an MCA in a rural (OR = 0.74) or high-volume pharmacy (OR = 0.65).ConclusionsThe most important determinant of receiving an MCA was having had a prior MCA. Overall, MCA recipients were healthier, younger, urban-dwelling, and taking fewer medications than non-recipients. Policies regarding current and future medication review programs may need to evolve to ensure that those at greatest need receive timely and comprehensive medication reviews.

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Paying pharmacists for patient care

Cited by 128 publications

References 46 publications

Randomized Trial of the Effect of Pharmacist Prescribing on Improving Blood Pressure in the Community

Randomized Trial of the Effect of Pharmacist Prescribing on Improving Blood Pressure in the Community

Beyond the four walls: an exploratory survey of location, employment and roles of pharmacists in primary health care

Factors affecting the delivery of community pharmacist-led medication reviews: evidence from the MedsCheck annual service in Ontario

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