title: Integrating family medicine and pharmacy to advance primary care therapeutics.
abstract: The prevalence of suboptimal prescribing of medications is well documented. Patients are often undertreated or not offered therapeutic treatments that are likely to confer benefit. As a result, drug-related hospital admissions are common and often preventable. Improvements to the health-care system are clearly needed in order to maximize the benefits that can be derived from medications. Many countries are changing their primary health-care systems to improve the quality of health-care delivery. One main transformation is the use of multidisciplinary care teams to provide care in a coordinated manner often from the same location or by using the common medical record of the patients. It has been demonstrated that pharmacists can improve prescribing, reduce health-care utilization and medication costs, and contribute to clinical improvements in many chronic medical conditions, such as cardiovascular disease, diabetes, and psychiatric illness. However, the effect of integrating a pharmacist providing general services into a primary care group has not been extensively studied. The Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) project was designed to provide a real-world demonstration of the feasibility of integrating the pharmacist into primary care office practice. This article provides a description of the IMPACT project participants; the IMPACT practice model and the concepts incorporated in its development; some initial results from the program evaluation; sustainability of the model; and some reflections on the implementation of the practice model.
authors.affiliation: Centre for Evaluation of Medicines, St. Joseph's Healthcare, Hamilton, Ontario, Canada. ldolovic@mcmaster.ca
authors.forename: L
authors.initials: L
authors.lastname: Dolovich
authors.forename: K
authors.initials: K
authors.lastname: Pottie
authors.forename: J
authors.initials: J
authors.lastname: Kaczorowski
authors.forename: B
authors.initials: B
authors.lastname: Farrell
authors.forename: Z
authors.initials: Z
authors.lastname: Austin
authors.forename: C
authors.initials: C
authors.lastname: Rodriguez
authors.forename: K
authors.initials: K
authors.lastname: Gaebel
authors.forename: C
authors.initials: C
authors.lastname: Sellors
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005194:Family Practice / Q000379:methods* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010593:Pharmaceutical Services / Q000639:trends; D010595:Pharmacists / Q000639:trends; D010604:Pharmacy / Q000379:methods / Q000639:trends; D011320:Primary Health Care / Q000379:methods* / Q000639:trends