Use of chronic disease management algorithms in Australian community pharmacies

Hana Morrissey, Patrick Ball, David Jackson, Louis Pilloto, Sharon Nielsen

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: In Australia, standardized chronic disease management algorithms are available for medical practitioners, nursing practitioners and nurses through a range of sources including prescribing software, manuals and through government and not-for-profit non-government organizations. There is currently no standardized algorithm for pharmacist intervention in the management of chronic diseases. 


    Aim: 
    To investigate if a collaborative community pharmacists and doctors' model of care in chronic disease management could improve patients' outcomes through ongoing monitoring of disease biochemical markers, robust self-management skills and better medication adherence. 


    Design: This project was a pilot pragmatic study, measuring the effect of the intervention by comparing the baseline and the end of the study patient health outcomes, to support future definitive studies. Algorithms for selected chronic conditions were designed, based on the World Health Organisation STEPS™ process and Central Australia Rural Practitioners' Association Standard Treatment Manual. They were evaluated in community pharmacies in 8 inland Australian small towns, mostly having only one pharmacy in order to avoid competition issues. The algorithms were reviewed by Murrumbidgee Medicare Local Ltd, New South Wales, Australia, Quality use of Medicines committee. They constitute a pharmacist-driven, doctor/pharmacist collaboration primary care model. The Pharmacy owners volunteered to take part in the study and patients were purposefully recruited by in-store invitation. 


    Results: Six out of 9 sites' pharmacists (67%) were fully capable of delivering the algorithm (each site had 3 pharmacists), one site (11%) with 2 pharmacists, found it too difficult and withdrew from the study, and 2 sites (22%, with one pharmacist at each site) stated that they were personally capable of delivering the algorithm but unable to do so due to workflow demands. 


    Conclusion: This primary care model can form the basis of workable collaboration between doctors and pharmacists ensuring continuity of care for patients. It has potential for rural and remote areas of Australia where this continuity of care may be problematic.

    Original languageEnglish
    Pages (from-to)176-196
    Number of pages21
    JournalResearch in Social and Administrative Pharmacy
    Volume11
    Issue number2
    DOIs
    Publication statusPublished - Apr 2015

    Fingerprint

    Pharmacies
    Disease Management
    Pharmacists
    Chronic Disease
    Primary Health Care
    Nursing
    Nonprofit Organizations
    South Australia
    New South Wales
    Continuity of Patient Care
    Profitability
    Self Care
    Medicare
    Health
    Software
    Biomarkers

    Cite this

    Morrissey, Hana ; Ball, Patrick ; Jackson, David ; Pilloto, Louis ; Nielsen, Sharon. / Use of chronic disease management algorithms in Australian community pharmacies. In: Research in Social and Administrative Pharmacy. 2015 ; Vol. 11, No. 2. pp. 176-196.
    @article{2c8340d2149d448591e99c2499013b0c,
    title = "Use of chronic disease management algorithms in Australian community pharmacies",
    abstract = "Background: In Australia, standardized chronic disease management algorithms are available for medical practitioners, nursing practitioners and nurses through a range of sources including prescribing software, manuals and through government and not-for-profit non-government organizations. There is currently no standardized algorithm for pharmacist intervention in the management of chronic diseases.  Aim: To investigate if a collaborative community pharmacists and doctors' model of care in chronic disease management could improve patients' outcomes through ongoing monitoring of disease biochemical markers, robust self-management skills and better medication adherence.  Design: This project was a pilot pragmatic study, measuring the effect of the intervention by comparing the baseline and the end of the study patient health outcomes, to support future definitive studies. Algorithms for selected chronic conditions were designed, based on the World Health Organisation STEPS™ process and Central Australia Rural Practitioners' Association Standard Treatment Manual. They were evaluated in community pharmacies in 8 inland Australian small towns, mostly having only one pharmacy in order to avoid competition issues. The algorithms were reviewed by Murrumbidgee Medicare Local Ltd, New South Wales, Australia, Quality use of Medicines committee. They constitute a pharmacist-driven, doctor/pharmacist collaboration primary care model. The Pharmacy owners volunteered to take part in the study and patients were purposefully recruited by in-store invitation.  Results: Six out of 9 sites' pharmacists (67{\%}) were fully capable of delivering the algorithm (each site had 3 pharmacists), one site (11{\%}) with 2 pharmacists, found it too difficult and withdrew from the study, and 2 sites (22{\%}, with one pharmacist at each site) stated that they were personally capable of delivering the algorithm but unable to do so due to workflow demands.  Conclusion: This primary care model can form the basis of workable collaboration between doctors and pharmacists ensuring continuity of care for patients. It has potential for rural and remote areas of Australia where this continuity of care may be problematic.",
    keywords = "algorithm, Australia, chronic disease, cooperation, disease management, human, medication compliance, organization and management, outcome assessment, pharmacist, pharmacy, physician, pilot study, primary health care, procedures, professional standard, self care, Algorithms, Chronic Disease, Community Pharmacy Services, Cooperative Behavior, Disease Management, Humans, Medication Adherence, Outcome Assessment (Health Care), Pharmacists, Physicians, Pilot Projects, Primary Health Care, Professional Role, Self Care",
    author = "Hana Morrissey and Patrick Ball and David Jackson and Louis Pilloto and Sharon Nielsen",
    year = "2015",
    month = "4",
    doi = "10.1016/j.sapharm.2014.06.002",
    language = "English",
    volume = "11",
    pages = "176--196",
    journal = "Research in Social and Administrative Pharmacy",
    issn = "1551-7411",
    publisher = "Elsevier",
    number = "2",

    }

    Use of chronic disease management algorithms in Australian community pharmacies. / Morrissey, Hana; Ball, Patrick; Jackson, David; Pilloto, Louis; Nielsen, Sharon.

    In: Research in Social and Administrative Pharmacy, Vol. 11, No. 2, 04.2015, p. 176-196.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Use of chronic disease management algorithms in Australian community pharmacies

    AU - Morrissey, Hana

    AU - Ball, Patrick

    AU - Jackson, David

    AU - Pilloto, Louis

    AU - Nielsen, Sharon

    PY - 2015/4

    Y1 - 2015/4

    N2 - Background: In Australia, standardized chronic disease management algorithms are available for medical practitioners, nursing practitioners and nurses through a range of sources including prescribing software, manuals and through government and not-for-profit non-government organizations. There is currently no standardized algorithm for pharmacist intervention in the management of chronic diseases.  Aim: To investigate if a collaborative community pharmacists and doctors' model of care in chronic disease management could improve patients' outcomes through ongoing monitoring of disease biochemical markers, robust self-management skills and better medication adherence.  Design: This project was a pilot pragmatic study, measuring the effect of the intervention by comparing the baseline and the end of the study patient health outcomes, to support future definitive studies. Algorithms for selected chronic conditions were designed, based on the World Health Organisation STEPS™ process and Central Australia Rural Practitioners' Association Standard Treatment Manual. They were evaluated in community pharmacies in 8 inland Australian small towns, mostly having only one pharmacy in order to avoid competition issues. The algorithms were reviewed by Murrumbidgee Medicare Local Ltd, New South Wales, Australia, Quality use of Medicines committee. They constitute a pharmacist-driven, doctor/pharmacist collaboration primary care model. The Pharmacy owners volunteered to take part in the study and patients were purposefully recruited by in-store invitation.  Results: Six out of 9 sites' pharmacists (67%) were fully capable of delivering the algorithm (each site had 3 pharmacists), one site (11%) with 2 pharmacists, found it too difficult and withdrew from the study, and 2 sites (22%, with one pharmacist at each site) stated that they were personally capable of delivering the algorithm but unable to do so due to workflow demands.  Conclusion: This primary care model can form the basis of workable collaboration between doctors and pharmacists ensuring continuity of care for patients. It has potential for rural and remote areas of Australia where this continuity of care may be problematic.

    AB - Background: In Australia, standardized chronic disease management algorithms are available for medical practitioners, nursing practitioners and nurses through a range of sources including prescribing software, manuals and through government and not-for-profit non-government organizations. There is currently no standardized algorithm for pharmacist intervention in the management of chronic diseases.  Aim: To investigate if a collaborative community pharmacists and doctors' model of care in chronic disease management could improve patients' outcomes through ongoing monitoring of disease biochemical markers, robust self-management skills and better medication adherence.  Design: This project was a pilot pragmatic study, measuring the effect of the intervention by comparing the baseline and the end of the study patient health outcomes, to support future definitive studies. Algorithms for selected chronic conditions were designed, based on the World Health Organisation STEPS™ process and Central Australia Rural Practitioners' Association Standard Treatment Manual. They were evaluated in community pharmacies in 8 inland Australian small towns, mostly having only one pharmacy in order to avoid competition issues. The algorithms were reviewed by Murrumbidgee Medicare Local Ltd, New South Wales, Australia, Quality use of Medicines committee. They constitute a pharmacist-driven, doctor/pharmacist collaboration primary care model. The Pharmacy owners volunteered to take part in the study and patients were purposefully recruited by in-store invitation.  Results: Six out of 9 sites' pharmacists (67%) were fully capable of delivering the algorithm (each site had 3 pharmacists), one site (11%) with 2 pharmacists, found it too difficult and withdrew from the study, and 2 sites (22%, with one pharmacist at each site) stated that they were personally capable of delivering the algorithm but unable to do so due to workflow demands.  Conclusion: This primary care model can form the basis of workable collaboration between doctors and pharmacists ensuring continuity of care for patients. It has potential for rural and remote areas of Australia where this continuity of care may be problematic.

    KW - algorithm

    KW - Australia

    KW - chronic disease

    KW - cooperation

    KW - disease management

    KW - human

    KW - medication compliance

    KW - organization and management

    KW - outcome assessment

    KW - pharmacist

    KW - pharmacy

    KW - physician

    KW - pilot study

    KW - primary health care

    KW - procedures

    KW - professional standard

    KW - self care

    KW - Algorithms

    KW - Chronic Disease

    KW - Community Pharmacy Services

    KW - Cooperative Behavior

    KW - Disease Management

    KW - Humans

    KW - Medication Adherence

    KW - Outcome Assessment (Health Care)

    KW - Pharmacists

    KW - Physicians

    KW - Pilot Projects

    KW - Primary Health Care

    KW - Professional Role

    KW - Self Care

    UR - http://www.scopus.com/inward/record.url?scp=84922478635&partnerID=8YFLogxK

    U2 - 10.1016/j.sapharm.2014.06.002

    DO - 10.1016/j.sapharm.2014.06.002

    M3 - Article

    VL - 11

    SP - 176

    EP - 196

    JO - Research in Social and Administrative Pharmacy

    JF - Research in Social and Administrative Pharmacy

    SN - 1551-7411

    IS - 2

    ER -