Marlies M. E. Geurts

Medication review practices in European countries

BACKGROUND Medication review procedures have been developed in many countries to improve rational and safe medication use. The similarities, comprehensiveness, and effectiveness of these procedures has not been assessed, or compared. OBJECTIVE The aim of this study was to explore medication review practices in European countries. METHODS An online survey was sent to 32 European countries (all 28 European Union countries and 4 other European countries) by email to one person in each country known to be aware of medication review practices in their country in May 2011. The informants were identified through Pharmaceutical Group of European Union. To complement and validate the information received through Pharmaceutical Group of European Union, medication review experts involved in Pharmaceutical Care Network Europe were contacted. The survey assessed comprehensiveness of the medication review procedures classified according to 3 types in terms of settings; access to patient clinical information; patient involvement; availability of documentation and information; collaboration with the physician; quality control, and training required. RESULTS Almost two thirds (64%) of the 25 European countries which responded (response rate 78%) indicated having at least one type of medication review procedure in their country. In the community setting prescription (type I) and adherence (type II) medication reviews were the most common (established in 9 and 11 countries, respectively). More comprehensive type III clinical medication reviews requiring access to clinical patient information were still rare, and just being established in 6 countries. CONCLUSIONS Medication review procedures are becoming common in health care throughout Europe, however improving their comprehensiveness would require better access to patient information for those professionals conducting clinical medication reviews. In addition to benchmarking, the inventory can enhance cooperation between countries and stakeholders involved in medication review practice development nationally and internationally.

The evaluation of an intervention based on the application of patient self-completion concordance forms in Dutch community pharmacies and the effect on adherence to chronic medication

OBJECTIVE To evaluate the use of patient self-completion concordance forms and to determine the effect of patient counselling by using concordance forms on adherence to chronic medication. METHODS Patients with a prescription for new chronic treatment were randomised in an intervention or control group. The intervention group received a concordance form to fill in at home and to discuss during a consultation 2 weeks later in the pharmacy. The control group received the usual information and instruction on how to use the medicine. Afterwards, all patients were asked to fill in a questionnaire about their use of medicines and contact with the pharmacy employees. Adherence to the medicine was determined using rates of prescription refills after 6 months of use. RESULTS The questionnaires showed that patients were satisfied about the concordance model. After 6 months of use, 79% of the patients from both intervention and control group were defined as adherent. CONCLUSIONS There was no significant difference found in adherence between intervention and control group. PRACTICE IMPLICATIONS Use five selected questions from the concordance form which provided most answers. Focus on one drug group and have more consultation moments.

Patient beliefs about medicines and quality of life after a clinical medication review and follow-up by a pharmaceutical care plan: a study in elderly polypharmacy patients with a cardiovascular disorder

To determine the effect of a clinical medication review, followed up by a pharmaceutical care plan, on the beliefs about medicines and quality of life (QoL) of older patients with polypharmacy and a cardiovascular disorder.

The evaluation of patient self-completion concordance forms used in community pharmacy : a comparison of two European countries

To evaluate the use of patient self‐completion concordance forms in Dutch and Bulgarian pharmacies. Second, to show any differences in pharmacy practice and patient behaviour in two European countries: the Netherlands and Bulgaria.

Development of a web-based pharmaceutical care plan to facilitate collaboration between healthcare providers and patients

BACKGROUND In medication therapy management there is a need for a tool to document medication reviews and pharmaceutical care plans (PCPs) as well as facilitate collaboration and sharing of patient data between different healthcare providers. Currently, pharmacists and general practitioners (GPs) have their own computer systems and patient files. To facilitate collaboration between different healthcare providers and to exchange patient data we developed a paper-based tool. As a result the structured collection of all relevant information for a clinical medication review was more protocol driven. The tool also enabled to plan interventions and follow-up activities: the PCP. The PCP was piloted among three GPs and six community pharmacists. Interviews with all healthcare providers concluded the PCP was found a very useful tool to collect and share patient data. A disadvantage was the time spent to collect all information. We therefore developed our PCP into a web-based tool: the web-based PCP (W-PCP). OBJECTIVES Development of a W-PCP to (1) provide healthcare providers with information from pharmacist- and GP computer systems and (2) facilitate collaboration between healthcare providers and patients. Development and Application: W-PCP facilitates uploading and sharing of patient data among health care professionals and collaboration between professionals and patients on performing treatment plans. The W-PCP is a stand-alone application developed by cocreation using a generic software platform that provides developmental speed and flexibility. METHOD The W-PCP was used in three research lines, two in primary care and one in a hospital setting. Outcomes measures were defined as satisfaction about efficiency and effectiveness during data sharing and documentation in providing care and conducting medication reviews using the W-PCP. First experiences concerning the use of W-PCP in a primary care setting were collected by a questionnaire and interviews with pharmacists and GPs using the W-PCP. RESULTS A questionnaire about first experiences with the W-PCP was sent to 38 healthcare providers. 17 healthcare providers returned the questionnaire (response 44.7%). The use of W-PCP resulted in positive experiences from participating healthcare providers. One of the needs expressed is to have the W-PCP application integrated in the current pharmacy and GP computer systems. All experiences, needs, and ideas for improvement of the current application were collected. On the basis of experiences and requirements collected, the application will be further developed. CONCLUSIONS The W-PCP application can potentially support successful collaboration between different healthcare providers and patients, which is important for medication therapy management. With this application, a successful collaboration between different healthcare providers and patients could be achieved.

The evaluation of patient self-completion concordance forms used in community pharmacy

To evaluate the use of patient self‐completion concordance forms in Dutch and Bulgarian pharmacies. Second, to show any differences in pharmacy practice and patient behaviour in two European countries: the Netherlands and Bulgaria.