The Development and Proof of Principle Test of TRIAGE: A Practical Question Set to Identify and Discuss Medication-Related Problems in Community Pharmacy

Vervloet, Marcia; Zwikker, Hanneke; Linn, Annemiek J.; Koster, Ellen S.; Gipmans, Suzan; Aarle, M. C. W. van; Dijk, Liset van

doi:10.3390/pharmacy8040178

Cited by 6 publications

(3 citation statements)

References 29 publications

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“…All chronic medication users that made use of the pharmacy refill service, in which their prescriptions are automatically renewed and distributed by community pharmacies after a given time period, were invited for a yearly consult. During that consult, pharmacy technicians discussed those patients medication use and improved their medication adherence based on consult preparation (TMI and MeMo) and a practical question set to identify problems (TRIAGE) [ 11 , 12 , 39 ].…”

Section: Methodsmentioning

confidence: 99%

Implementing medication adherence interventions in four Dutch living labs; context matters

Hogervorst,

Vervloet,

Janssen

et al. 2023

BMC Health Serv Res

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Background Despite the abundant availability of effective medication adherence interventions, uptake of these interventions into routine care often lacks. Examples of effective medication adherence interventions include telephone counseling, consult preparation and the teach-back method. Assessing context is an important step in understanding implementation success of interventions, but context is often not reported or only moderately described. This study aims to describe context-specific characteristics in four living labs prior to the implementation of evidence-based interventions aiming to improve medication adherence. Methods A qualitative study was conducted within four living labs using individual interviews (n = 12) and focus groups (n = 4) with project leaders and involved healthcare providers. The four living labs are multidisciplinary collaboratives that are early adopters of medication adherence interventions in the Dutch primary care system. Context is defined as the environment or setting in which the proposed change is to be implemented. Interview topics to assess context were formulated based on the ‘inner setting’ and ‘outer setting’ domains of the Consolidated Framework for Implementation Research (CFIR). Interviews were recorded and transcribed verbatim. Transcripts were deductively analyzed. Results A total of 39 community pharmacists, pharmacy technicians, general practitioners and a home care employee participated in the (focus group) interviews. All four living labs proved to be pharmacy-driven and characterized by a high regard for innovation by staff members, a positive implementation climate, high levels of leadership engagement and high compatibility between the living labs and the interventions. Two living labs were larger in size and characterized by more formal communication. Two living labs were characterized by higher levels of cosmopolitanism which resulted in more adaptable interventions. Worries about external policy, most notably lack of reimbursement for sustainment and upscaling of the interventions, were shared among all living labs. Conclusions Contextual characteristics of four living labs that are early adopters of medication adherence interventions provide detailed examples of a positive implementation setting. These can be used to inform dissemination of medication adherence interventions in settings less experienced in implementing medication adherence interventions.

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Section: Methodsmentioning

confidence: 99%

Implementing medication adherence interventions in four Dutch living labs; context matters

Hogervorst,

Vervloet,

Janssen

et al. 2023

BMC Health Serv Res

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show abstract

“…6 This decrease may indicate an underestimation of the pharmacy's crucial patient-oriented role, potentially hampering the effectiveness of patient counselling by the pharmacy team. [7][8][9] The general public may not be aware of this shift of the community pharmacy team's focus and to some extent not yet be aware of what they can expect from the pharmacy team regarding patient-centred healthcare. 7 In the Netherlands, the pharmacy team consists of both pharmacists and pharmacy technicians (PTs).…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Patient Trust in the Pharmacy Team: Findings from a Mixed Method Study Involving Patients with Asthma & COPD

te Paske,

van Dijk,

Yilmaz

et al. 2023

PPA

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The pharmacy team has been shifting its role from primarily dispensing medications to providing patient-centred pharmaceutical care. Establishing a trust relation between the pharmacy team and their patients is fundamental for this new role. This study aimed to (i) identify the level of trust in the pharmacy team among patients with asthma and/or COPD, (ii) assess whether the level of trust patients have in pharmacists differs from their trust in pharmacy technicians, and (iii) identify factors that contribute to building trust in the pharmacy team. Patients and Methods: First, a focus group with six patients with asthma and/or COPD was conducted to explore which aspects they considered significant for establishing trust in the pharmacy team. Subsequently, these insights were used to develop an online questionnaire. A link to the online questionnaire was distributed among patients with asthma and/or COPD. Data were analysed using exploratory factor analyses to identify underlying constructs for trust. Regression analyses were conducted to evaluate whether these constructs affected trust (scale 1-10) in the pharmacy team. Results: A total of 290 patients completed the questionnaire. On average, they rated their trust in the pharmacy team with a score of 7.4 out of 10 (SD: 1.5), almost identical to their trust in the pharmacist and pharmacy technician. Patient trust in pharmacy teams is influenced by their perception of engagement, expertise in medication-related matters, and effective communication. Conclusion: Trust in the pharmacy team was observed as moderately high, indicating that there is room for improvement. Due to the changing role of the pharmacy team, its members should strive to enhance their patient-centred skills ensuring ongoing efforts to build and maintain trust with patients.

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“…All chronic medication users that make use of the pharmacy refill service, in which their prescriptions are automatically renewed and distributed by community pharmacies after a given time period, are invited for a yearly consult. During that consult, they discuss their medication use and improve their medication adherence based on consult preparation (TMI and MeMo), and a practical question set to identify problems (TRIAGE) by pharmacy technicians (Linn et al, 2018;Stuurman-Bieze et al, 2013;Vervloet, Zwikker, Linn, Koster, et al, 2020).…”

Section: Living Lab Bmentioning

confidence: 99%

Implementation and scalability of primary care interventions to improve patients medication use

Hogervorst

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Treatment with medicines is the single most used method for treating patients with chronic conditions and to prevent further damage of the disease. The use of medicines is agreed upon between healthcare provider and patient and is only effective if used correctly. However, medication use is problematic for many patients and drug-related problems are common when patients do not succeed in following their treatment. Non-adherence to treatment regimens is a major drug-related problem in 44 to 77% of chronic medication users. Many evidence-based medication adherence interventions have been developed for healthcare providers to better support patients in taking their medication. These interventions are often complex, as they must be tailored to diverse patient populations, rely on close collaboration between different healthcare providers, and require continuous monitoring of non-adherent patients. This complexity means that for these interventions to be effective, they must be continuously available for patients by a multidisciplinary team of healthcare providers. As such, they need to be fully integrated into daily clinical practice systems in a (cost-)effective manner. However, so far, their implementation is often lacking. Integrating complex interventions into daily clinical practice is complex. It requires tailoring the intervention to the context in which they will be implemented, which requires using implementation strategies that fit within the context. In order to do so, detailed information about the setting and its context is required. However, current publications on interventions generally do not provide sufficient details about the implementation and the context to be reproduced in different settings. This tailoring can be supported by dissemination and implementation science methods, which offer different models and theories on implementing complex interventions into daily clinical practice. Throughout this thesis, we provide insight into how medication use of patients with a chronic disease can be optimized by improving the implementation and scale-up of medication adherence interventions in primary care. This was described in five chapters (chapters 2 to 6). We discussed our main findings and drew conclusions in chapter 7.

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The Development and Proof of Principle Test of TRIAGE: A Practical Question Set to Identify and Discuss Medication-Related Problems in Community Pharmacy

Cited by 6 publications

References 29 publications

Implementing medication adherence interventions in four Dutch living labs; context matters

Implementing medication adherence interventions in four Dutch living labs; context matters

Factors Associated with Patient Trust in the Pharmacy Team: Findings from a Mixed Method Study Involving Patients with Asthma & COPD

Implementation and scalability of primary care interventions to improve patients medication use

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