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THE FUTURE OF PHARMACY
INTERNATIONAL PHARMACY JOURNAL
The Cent e r p r o v i d e d BNHI an int e r i m r e p o r t in Augus t 2 0 1 0 fo r t h e r e s u l t s f r o m Febr u a r y t o Jun e a n d a fin a l r e p o r t in Febr u a r y 2 0 1 1 fo r t h e wh o l e y e a r. The re s u l t s co n s i s t of t hr e e a sp e c t s - c l i n i c a l , hum a n i s t i c a n d e c o n o m i c o ut c o m e s . The clin i c a l o ut c o m e co n s i s t s of t h e da t a f r o m t h e inf o r m a t i o n we co ll e c t e d f r o m t h e p r a c t i c i n g p h a r m a c i s t s , in c l u d i n g ge n d e r, a g e , r e a s o n s fo r hig h us e of o ut p a t i e nt s e r v i c e s , a n d a n a n a l y s i s of dr u g t h e r a p y p r o b l e m s . The hum a n i s t i c o ut - c o m e p r e s e nt s t h e r e s u l t s f r o m t w o sur v e y s of p a t i e nt s ’ qu a l - i t y of lif e a n d o n e s a t i s f a c t i o n sur v e y. Fina ll y t h e e c o n o m i c o ut c o m e co n s i s t s of t h e a n a l y s i s of cl a i m e d - d a t a b a s e f r o m BNHI on num b e r of v i s i t s , t ot a l h e a l t h c a r e e x p e n d i t u r e s , dr u g e x p e n d i t u r e s , a n d co s t - b e n e fi t r e s u l t .
The clinical outcome Patient characteristics Among a t ot a l of 8 0 8 p a t i e nt s wh o we r e in c l u d e d in t h e pr o j e c t , t h e r e w a s a hig h e r p r o p o r t i o n of ma l e p a t i e nt s WT "UUIFTBNFUJNFBIJHIFSQSPQPSUJPOPG QBUJFOUTXFSFNBMFJOCPUI5BJQFJBOE,BPQJOHBSFBT BOE TFF'JH
p a t i e nt s ’ h e a l t h c a r e n e e d s , d e v e l o p i n g a n d im p l e m e nt i n g c a r e p l a n s , a n d fo ll o w - u p a n ot h e r 7 t im e s a ye a r fo r b e t t e r o ut c o m e s of int e r v e nt i o n s . Wh e n t a lk i n g t o t h e p a t i e nt s a n d t h e i r f a m i l y o r c a r e gi v e r s , p h a r m a c i s t s will n ot o nl y p r o v i d e dr u g - s p e c i fi c inf o r m a t i o n , b ut a l s o e du c a t e t h e m a b o u t t h e i r s e lf - c a r e t e c h n i q u e s a n d p r o p e r m e d i c a l - s e e k i n g b e h a v i o u r s . Hopef u l l y by p r o v i d i n g t h e m wit h p h a r m a c e u t i c a l c a r e a n d p e r s o n a l at t e nt i o n , t h e s e p a t i e nt s will ult i m a t e l y c h a n g e t h e i r p hy s i c i a n v i s i t b e h a v i o u r a n d ch o o s e o n e p hy s i c i a n t h e y t r u s t t o go t o a n d o n e p h a r m a c y t o di s p e n s e a ll t h e i r p r e s c r i p t i o n s .
The p at i e nt li s t wa s p r o v i d e d by t h e BNHI, an d t h e Cent e r a sk e d t h e qu a l i fi e d p h a r m a c i s t t o ch o o s e t h e p a t i e nt s h e / s h e w a nt s t o t a k e c a r e of, m e a n i n g c l o s e t o t h e p h a r m a c y h e / s h e p r a c t i c e at (s e e Fig . 2 ) . The ph a r m a c i s t - m a t c h e d p a t i e nt n a m e li s t will s e n d t o t h e BNHI for t h e m t o ge n e r a t e a le t t e r t o s e n d t o t h e in d i v i d u a l p a t i e nt a n d inf o r m him / h e r whi c h p h a r m a - c i s t will co nt a c t t h e m a n d p r o v i d e t h e h o m e v i s i t . Afte r co n - t a c t i n g by p h o n e by t h e p h a r m a c i s t a n d t h e p a t i e nt a g r e e d t o jo i n t h e p r o g r a m , we de fi n e d t hi s a s a v a li d c a s e . It t a k e s a r o u n d o n e h o u r t o co n d u c t t h e c a r e at p a t i e nt ’ s h o m e . Afte r e a c h v i s i t , t h e p h a r m a c i s t s h a v e t o fill o ut sp e c i fi c fo r m s t o r e c o r d t h e inf o r m a t i o n t h e y o bt a i n f r o m t h e p a t i e nt s a n d t h e i r c a r e p l a n s . Wh e n co m m u n i c a t i n g wit h t h e p hy s i c i a n s , t h e y a l s o n e e d t o p r e s e nt t h e p hy s i c i a n s wit h t h e p a t i e nt s ’ co m p l e t e m e d i c a t i o n p r ofi l e a n d a co m m u n i c a t i o n fo r m s t a t i n g wh a t t h e dr u g t h e r a p y p r o b l e m s we r e a n d wh a t t h e i r sug g e s t i o n s a r e . Then t h e p h a r m a c i s t s co u l d m a k e t h e cl a i m of t h e s e r v i c e t o t h e BNHI, an d t h e y will ge t r e i m b u r s e m e nt f r o m BNHI of NT$ 1 , 0 0 0 (a r o u n d US$ 35) p e r v i s i t . For e a c h v a li d c a s e , t h e p h a r m a c i s t s c a n v i s i t up t o 8 t im e s a ye a r a n d cl a i m e d fo r t h e s e r v i c e e a c h t im e , m e a n i n g t h e p h a r m a c i s t s c a n r e c e i v e up t o NT$ 8 , 0 0 0 / y e a r.
Results Twent y - t h r e e p h a r m a c i s t s in Taip e i D i s t r i c t (fo u r c it i e s) a n d 19 p h a r m a c i s t s in K a o p i n g D i s t r i c t (a n o t h e r fo u r cit i e s) s t a r t e d t o p r o v i d e h o m e p h a r m a c e u t i c a l c a r e fo r 8 0 8 hig h us e r s f r o m Febr u a r y t o D e c e m b e r 2 0 1 0 . The re c r u i t i n g r a t e JTBSPVOE JOEJDBUJOHIJHISFKFDUJPOPGIPNFWJTJUCZUIF p a t i e nt s . The av e r a g e dur a t i o n of s e r v i c e s w a s 8 .3 m o nt h s .
Center for Pharmaceutical Care Development
Match patients with pharmacists
Discover problems Decide solutions Execute care plans Follow up results
Obtain the list of high users
Train pharmacists
Pharmacists complete home visits and collect data
EDUCATE, MONITOR, SUPERVISE, IMPROVE PROCESS
Academic support system
Fig. 2. The responsibilities of Center for Pharmaceutical Care Development
Fig. 3. Gender distribution in different areas
260 240 220 200 180 160 140 120 100 80 60 40 20 0
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