Impact of domiciliary pharmacy visits on medication management in an elderly population

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Abstract
This paper describes medication management by elderly patients living in their own homes, and the effects of patient counselling during five domiciliary pharmacy visits on patient compliance and medication management. The 190 subjects who completed the 12-month study were randomly allocated to either an intervention group (receiving counselling on the correct use and storage of their drugs during five domiciliary visits), a control (V) group (receiving visits but no counselling), or a control (NV) group (having no contact between an initial visit and the end of the study). The patients' drug knowledge, dexterity and cognitive functioning were assessed, and patients in all three groups were well matched at baseline. At each follow-up visit, patient compliance was measured using pill counts and interviews. After the initial visit, patients in the intervention group demonstrated better compliance, better drug storage practices and a reduced tendency to hoard drugs, and required fewer GP consultations, than patients in either of the control groups. The provision of the domiciliary pharmacy service was effective in detecting drug-related problems in a potentially high risk patient group. The effectiveness of such a service may be improved by increased transfer of patient information between community pharmacists and general medical practitioners.