Since October 2010, Swiss community pharmacies can offer a 'Polymedication Check' (PMC) to patients on ≥4 prescribed drugs taken over ≥3 months. Aims: To evaluate first experiences shortly after implementation, missed pharmaceutical care issues and barriers to implementation on pharmacist's level as well as patient's acceptance through qualitative and descriptive studies To evaluate the impact of PMC in Swiss primary Care and to evaluate economic, clinical and humanistic outcomes in a subsequent randomized controlled trial.
Evaluating the newly implemented Swiss 'Polymedication-Check', a specialised medication review and screening for adherence issues, offers a large field of interesting research questions. Using the current PMC-Protocol as a structured interview guide, pharmacists are able to document their counselling on medication use issues and other drug related problems. In a randomized-controlled trial we aim at analysing 800 recruited patients from 70 study pharmacies during seven months. Patients were recruited in the regions Basel, Aargau-Solothurn, Waadt in Switzerland and randomised using 1:1 block randomisation. Primary outcome focuses on the improvement of adherence and persistence after 'Polymedication Check' (using medication possession ratio (MPR), gaps in medicines history records and patient's interviews). Second outcomes are time to planned or unplanned consulting with a physician or hospitalisation, knowledge, safety of medicines use and patients management of polypharmacy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
450
Polymedication Check (PMC) is a pharmacist's led medication review focusing medicines management, adherence issues and other drug related problems. The PMC has been implemented in 2010 as a new cognitive service provided by any community pharmacist to patient with polypharmacy (n\>3 drugs) on long term conditions (\> months). This specialised medication review follows a structured predefined protocol and is reimbursed by swiss health insurances. As an outcome, pharmacist may install a compliance support e.g. weekly filled pill organizer.
Pharmaceutical Care Research Group, University of Basel
Basel, Basel, Switzerland
Medication possession ratio (MPR), gaps and persistence in medicines use
Improvement of adherence seven months after 'Polymedication-Check' using medication possession ratio (MPR), gaps and persistence out of history records from community pharmacy.
Time frame: Seven months after recruitment
Time to planned or unplanned consulting with a physician or hospitalisation
Time to planned or unplanned consulting with a physician or hospitalisation
Time frame: Seven months after recruitment
Patient knowledge about his medicines
Patient knowledge about his medicines use, assessed through PMC (intervention goup) and two telephone interviews (both groups)
Time frame: After two weeks, four and seven months after recruitment
Self reported adherence
Self report of adherence: is assessed with self administrated questionnaires and telephone interviews
Time frame: At study start and two weeks, four and seven months after after recruitment
Patients safety
Patients safety is assessed through a) telephone interview with a focus on perceived safety and b) number of drug related problems addressed and solved at study end.
Time frame: After two weeks, four and seven months after recruitment
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