Use of point-of-service health status assessments by community pharmacists to identify and resolve drug-related problems in patients with musculoskeletal disorders.
OBJECTIVE
To determine whether community pharmacists can use point-of-service health status assessments to identify and resolve drug-related problems (DRPs) in ambulatory patients with selected musculoskeletal (MSK) disorders.


METHODS
Twelve-month, prospective, multicenter demonstration project.


METHODS
Twelve independent community pharmacies in eastern Iowa.


METHODS
Ambulatory patients with self-reported diagnosis of osteoarthritis, rheumatoid arthritis, or low back pain.


METHODS
During quarterly pharmacy visits for 1 year, patients used touch-screen computers to report their health status. Patients answered questions on the Short Form-36 (SF-36) general health survey, as well as questions assessing limitations associated with their MSK condition. Pharmacists used this data in interviewing patients to assess for DRPs.


RESULTS
The study enrolled 461 patients, of whom 388 returned for the 12-month visit. During this 1-year period, community pharmacists identified 926 cumulative DRPs. Patients with no DRPs had significantly higher physical component summary scores on the SF-36 (p<0.05) than patients with more than one DRP at baseline (36.2 vs 31.6), 6 months (39.2 vs 33.3), and 12 months (40.1 vs 35.4). At 12 months, actions performed by pharmacists led to resolution or improvement of 70.7% of DRPs.


CONCLUSIONS
Drug-related problems are numerous in community-dwelling patients with MSK disorders and correspond to decreased physical health status. Community pharmacists can use patient-reported measures of health status to identify DRPs and initiate processes to resolve them.
Ernst
M E
ME
Division of Clinical and Administrative Pharmacy, College of Pharmacy, University of Iowa at Iowa City, 52242, USA. michaelernst@uiowa.edu
Doucette
W R
WR
Dedhiya
S D
SD
Osterhaus
M C
MC
Kumbera
P A
PA
Osterhaus
J T
JT
Townsend
R J
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D004358:Drug Therapy / Q000379:methods; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006304:Health Status; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000188:drug therapy*; D020380:Needs Assessment / Q000458:organization & administration*; D010003:Osteoarthritis / Q000188:drug therapy; D010353:Patient Education as Topic / Q000379:methods; D010594:Pharmacies / Q000458:organization & administration*; D011446:Prospective Studies; D012017:Referral and Consultation; D011795:Surveys and Questionnaires