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AMBULATORY CARE

Patient Evaluation of a Community Pharmacy Medications Management Service

Research Assistant, Department of General Practice and Primary Care, and Health Economics Research Unit, University of Aberdeen, Aberdeen, Scotland

Christine Bond, PhD

Professor of Primary Care (Pharmacy), Department of General Practice and Primary Care, University of Aberdeen

Alison Blenkinsopp, PhD

Professor, Department of Medicines Management, University of Keele, Keele, England

Mariesha Jaffray, MSc

Research Fellow, Department of General Practice and Primary Care, University of Aberdeen

Margaret Watson, PhD

Senior Research Fellow, Department of General Practice and Primary Care, University of Aberdeen

Philip Hannaford, PhD

NHS Grampian Professor of Primary Care, Department of General Practice and Primary Care, University of Aberdeen

the Community Pharmacy Medicines Management Evaluation Team^a

Reprints: Dr. Tinelli, Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Rd., Aberdeen, AB25 2AY, Scotland, fax 44 (0)1224-550683, m.tinelli{at}abdn.ac.uk

BACKGROUND: A patient-centered approach is increasingly recognized as an important component in the evaluation of healthcare services.

METHODS: Postal questionnaire surveys were completed at baseline and after 12 months (follow-up) as part of a randomized controlled trial of the service. The setting was 9 primary care organizations in England. Patients with coronary heart disease were recruited from general practice registers and randomly allocated to the intervention (pharmacy-led medications management service) or control group.

RESULTS: Survey response rates at baseline and follow-up were 88.4% (1232/1394) and 80.1% (1085/1355), respectively. The respondents indicated that they wanted pharmacists to provide dispensing, medications review, advice on medications and health, private consultation areas, and short visit times. At follow-up, intervention patients were more likely than control patients (p < 0.01) to rate the service provided by their pharmacist with a higher level of satisfaction, and most intervention patients stated a preference for seeing their physician to discuss their medications, although this was less marked than in control patients (76% vs 85%; p < 0.01). Intervention patients were also more willing than control patients to ask the pharmacist questions that they would be unable to ask a physician (20% vs 11%, respectively; p < 0.01), to ask the pharmacist questions about their medications (32% vs 18%, respectively; p < 0.01), and to recommend this practice to others (51% vs 40%, respectively; p < 0.01).

CONCLUSIONS: Pharmacist intervention was associated with significant and positive changes in patient satisfaction. While patients probably continue to prefer a physician-led service, they value aspects of a pharmacy service. Patients generally preferred discussing medications with the family physician, but experiencing the community pharmacy–led service resulted in an attitudinal shift toward the pharmacist. These findings suggest a benefit in developing the community pharmacist's role as a reviewer of, and adviser on, patients' medications.

Key Words: community pharmacy services

Published Online, October 30, 2007. www.theannals.com, DOI 10.1345/aph.1K242