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 language | English |
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Pages (from-to) | 176-196 |
Number of pages | 21 |
Journal | Research in Social and Administrative Pharmacy |
Volume | 11 |
Issue number | 2 |
DOIs | |
Publication status | Published - Apr 2015 |