Developing and evaluating a model for pharmaceutical care in Australian community pharmacies

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Abstract
Objective To develop and evaluate a medication management service. The service was based on the principles of pharmaceutical care and targeted patients at risk of medication misadventure, primarily elderly patients, in five community pharmacies. Methods In phase one, pharmacists defined the service in consultation with consumers, medical practitioners and professional pharmacy organisations. Agreed characteristics of the service were: patient selection criteria, a structured patient care process, systematic documentation, a quality assurance process and a complementary relationship with services of other health professionals. Implementation and evaluation of the service occurred in the second phase. The service was provided over an 11-month period to 205 patients. Key findings Of the patients who received the service, 179 (87 per cent) had one or more medication or health-related problems. Pharmacists identified a total of 526 problems. Follow-up was available for 432 problems and 75 per cent of these problems were well managed by the end of the study. Of the 115 consumers surveyed, 74 responded. Eighty-five per cent of respondents believed the service had made a “significant” or “great” contribution to their health and 64 per cent thought that their knowledge of their medication had improved. Health economic evaluation indicated that net cost benefits were delivered to the health system. The net annual cost savings per patient ranged from $A40 to $A311. Conclusion Pharmacists were able to apply the principles of pharmaceutical care to meet the needs of at-risk consumers in the community. Further development of this service delivery model is under way and would appear to offer substantial advantages to consumers and the health system.

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