Community pharmacy based provision of pharmaceutical care to older patients.
OBJECTIVE
To measure the outcomes of a harmonized, structured pharmaceutical care programme provided to elderly patients by community pharmacists.


METHODS
A randomised, controlled, longitudinal, clinical trial with repeated measures was performed over an 18-month period, involving community pharmacies (5 intervention and 5 control) in Northern Ireland. Elderly, ambulatory patients (> or = 65 years), taking 4 or more prescribed medications were eligible for participation. Patients attending an intervention pharmacy received education on medical conditions, implementation of compliance strategies, rationalizing of drug regimens and appropriate monitoring; patients attending control sites received normal services. A battery of clinical, humanistic and economic outcomes were assessed.


RESULTS
A significantly higher proportion of intervention patients were compliant at the end of the 18-month study and experienced fewer problems with medication compared to control patients (P < 0.05). There was little impact on quality of life and health care utilisation.


CONCLUSIONS
Pharmaceutical care provision to community-dwelling patients resulted in an improvement in medication compliance and evidence of cost-savings. Future pharmaceutical care studies may benefit from a more focussed selective approach to data collection and outcomes measurement.
Clinical and Practice Research Group, School of Pharmacy, Queen's University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland.
Ian K
IK
Sturgess
James C
JC
McElnay
Carmel M
CM
Hughes
Grainne
G
Crealey
D000368:Aged; D003157:Community Pharmacy Services / Q000191:economics / Q000592:standards*; D003365:Costs and Cost Analysis; D003625:Data Collection; D004358:Drug Therapy / Q000191:economics / Q000592:standards*; D004363:Drug Utilization; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009660:Northern Ireland; D010349:Patient Compliance; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D010595:Pharmacists; D011788:Quality of Life; D016896:Treatment Outcome