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Implementation of medication review with follow-up in a Spanish community pharmacy and its achieved outcomes

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Abstract

Background Despite many research studies demonstrating the benefit in clinical, economic, and humanistic outcomes of professional pharmacy services, there is a paucity of evidence when these services become incorporated into the usual practice of a community pharmacy. Objective The objective of the present study was to evaluate the clinical, economic, and humanistic impact of a pharmacist-conducted medication review with follow-up following 18 months implementation. Setting Community pharmacies in Spain. Method The study used an effectiveness-implementation hybrid design. During the follow-up, patients attended the pharmacy on a monthly basis and received the medication review with follow-up service. Main outcome measure Economic, clinical, and humanistic measures were used to assess the impact of the service. Results 132 patients received the service. During the 18 months of follow-up, 408 negative outcomes related to medicines (which are uncontrolled health problems) were identified, of which 393 were resolved. The average number of medicines used by patients significantly decreased from 6.1 (SD: 2.9) to 3.3 (SD: 2.2). A significant decrease was also observed in hospitalizations [OR = 0.31 (IC 95 % = 0.10–0.99)] and in emergency department visits [OR = 0.16 (IC 95 % = 0.05–0.55); p = 0.001]. A general trend to increase all quality of life domains was observed over time. The higher increase was observed in the construct health transition [mean increase: 30.7 (SD: 25.4)], followed by bodily pain [mean increase: 22.3 (SD: 25.4)], and general health [mean increase: 20.7 (SD: 23.7)]. Medication knowledge significantly increased in terms of aggregated domains of dose, frequency, drug indication [from 8.9 (SD: 17.5) to 87.9 (SD: 25.0)], and dose and frequency [from 9.3 (SD: 17.9) to 92.5 (22.1)]. Although a slight improvement was observed in terms of drug indication, this increase was not statistically significant. 68 out of 132 patients (51.5 %) were non-adherent to their treatment. This number decreased to 1 (0.8 %) after the follow-up [OR = 0.007 (IC 95 %: 0.001–0.053) p < 0.001]. Conclusion A community pharmacy based medication review with follow-up service delivered by a trained pharmacist, has positive effects across clinical, economic, and humanistic outcomes. These results are consistent with previous studies. Incorporating community pharmacists into the multidisciplinary team is a reliable solution to improve health care.

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Funding

This work was financially supported by the participant pharmacy. No external funding was provided.

Conflicts of interest

All the authors have declared that they have no conflict of interest.

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Authors and Affiliations

  1. Grupo de Investigacion en Atencion Farmaceutica, Facultad de Farmacia, Universidad de Granada, Campus de Cartuja s/n, 18071, Granada, Spain

    Carla Castrillon Ocampo, Victoria Garcia-Cardenas, Fernando Martinez-Martinez & Miguel Angel Gastelurrutia

  2. Graduate School of Health, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia

    Victoria Garcia-Cardenas & Shalom I. Benrimoj

  3. Grupo Promoción y Prevención Farmacéutica, Departamento de Farmacia, Universidad de Antioquia UdeA, Calle 70 No 52–21, Medellín, Colombia

    Pedro Amariles

Authors
  1. Carla Castrillon Ocampo
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  2. Victoria Garcia-Cardenas
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  3. Fernando Martinez-Martinez
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  4. Shalom I. Benrimoj
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  5. Pedro Amariles
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Correspondence to Victoria Garcia-Cardenas.

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Ocampo, C.C., Garcia-Cardenas, V., Martinez-Martinez, F. et al. Implementation of medication review with follow-up in a Spanish community pharmacy and its achieved outcomes. Int J Clin Pharm 37, 931–940 (2015). https://doi.org/10.1007/s11096-015-0145-9

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