Clinical Pharmacy

Biography

Biography: Hana Morrissey

Abstract

Introduction: Most Australians spend their last 30 years taking at least one medication and their last 10 years taking multiple medications. The burden of chronic disease is increasing affecting people’s quality-of-life and increasing health system expenditures. Medication adherence is reported to be less than 33%. Patients with a chronic disease collect prescription repeats every month, creating an opportunity for further regular intervention by the community pharmacist. Aim: To investigate if a collaborative community pharmacist and GP model of care in Chronic Disease Management in rural Australia could improve patients’ outcomes through better monitoring of disease markers, increased self-management skills and greater medication adherence. Design: This project was a pilot before and after, pragmatic study, which was designed as a foundation to support future definitive studies. The clinical intervention phase was minimally invasive (finger pricks) and did not involve any active medication administration. It was based upon evidence-based guidelines, adapted for use in a pharmacy setting. The data was analysed in ASReml-R™ using linear mixed models or generalised linear mixed models. Results: Using a modified Health Education Impact Questionnaire™, there was 29.6% improvement in patients’ total score from before to after the intervention. There was significant change in medication number. There was no significant change on most measured parameters except of blood pressure, total cholesterol and monofilament pressure sensitivity from before and after the study. Limitation: Small sample due to the nature of small population residing in rural Australia and the contemporaneous introduction of Medicare locals and the 5th Community Pharmacy Agreement. Conclusion: Early detection and early intervention will improve quality of life and reduce disease and drug related problems. Blood pressure, total cholesterol, blood glucose level parameters are possible to monitor in the community pharmacy setting. The poor communication culture between pharmacist and doctors has a significant problems resulting in a disconnection in the continuity of care which may compromise patients’ outcomes. This appears to be a missed opportunity that needs to be nationally addressed.