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Evaluation of a home-based service for medication review in Swiss community pharmacies: a study protocol

  • At: PPR 2022 (2022)
  • Type: Poster
  • By: ESCAITH, Mathilde (Unisanté)
  • Co-author(s): Mathilde Escaith, Phd Student, Unisanté, Switzerland
    Noelia Amador-Fernandez, Research fellow, Unisanté, Switzerland
    Elodie Simi, Pharmacist, PharmaciePlus, Switzerland
    Clemence Perraudin, Research Fellow, Unisanté, Switzerland
    Anne Niquille, Research Fellow, Unisanté, Switzerland
    Patricia Quinatana Barcena, Research Fellow, McGill University - Faculty of medecine, Department of Surgery, Canada
    Jérôme Berger, PD-MERc, Unisanté, Switzerland
  • Abstract:

    Background
    Polymedication and medication hoarding in patients’ homes may increase the risk of drug-related problems (DRPs), but also an inadequate use or management of medication is a source of DRP. Community pharmacists can efficiently identify, prevent and manage these DRPs. In Switzerland, no pharmacy service that focus on the management of DRPs related to patients’ practice is currently recognized and remunerated. The medication review with follow up (MRF) at the patient’s home, aims to detect DRPs related to medication management at home and self-medication, with an emphasis on issues that cannot be detected in a community pharmacy (CP), like wrong medication storage. This service also provides a systematic review of the patient’s treatments.
    Purpose
    To evaluate the impact of the MRF service for adults with polypharmacy in Swiss CP for the identification and management of DRPs.
    Method
    A pre-post intervention study will be carried out in CPs in the French speaking region of Switzerland for 15 months. Volunteer pharmacists will include adults with a prescription of at least four chronic drugs for at least three months. Trained pharmacist will conduct three-structured domiciliary consultation at 6 months interval to deliver the service. The primary outcome of the study is the identification and management of DRPs. Secondary outcomes are patients’ knowledge about their treatments, number of expired or untaken medications and description of pharmaceutical interventions.
    Results
    A funding request for the study is currently underway. The study will be carried out in collaboration with CPs from the PharmaciePlus® group. The Ethics Committee (CER-VD) concluded that the study does not fall under the Human Research Act. Between 20 and 40 CPs will be enrolled to recruit at least 168 patients, selected from a pool of randomized and eligible patients through a sequence of computer-generated random numbers. A validated tool (ReMeDo tool) will guide pharmacists before, during and after the consultation. Educational training and support for pharmacists will increase quality of service provision and fidelity of study protocol.
    Conclusion
    This study will evaluate the impact of a new service that includes validated, structured and standardized interventions, training and supervision for CP staff, self-medication evaluation and use of home-based patient data. MRF is an enhanced service that aim to complete those currently provided in Switzerland in order to identify, manage and prevent DRPs. MRF is designed to provide a follow-up service aimed to patients that cannot come to a CP.
    Topic area: medication review; home care services; pharmacists; Switzerland

Last update 4 October 2019

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