Evaluation of a training and communication-network nephrology program for community pharmacists.
OBJECTIVE
To assess the feasibility and impact of implementing ProFiL program to optimize community-pharmacist management of drug-related problems among chronic kidney disease patients followed in a predialysis clinic. The program comprises a training workshop, communication-network program and consultation service.


METHODS
Forty-two community pharmacies, 101 pharmacists, and 90 chronic kidney disease patients attending a predialysis clinic in Laval (Canada). Patients were followed-up for 6 months.


METHODS
In a six-month, pilot, open, cluster-randomized controlled trial, community pharmacies were assigned to ProFiL or the usual care. Chronic kidney disease patients of these pharmacies attending a predialysis clinic were recruited. ProFiL pharmacists attended a workshop, received patient information (diagnoses, medications, and laboratory-test results) and had access to a consultation service. Their knowledge and satisfaction were measured before and after the workshop. The mean numbers of pharmacists' written recommendations to physicians (pharmaceutical opinions) and refusals to dispense a medication were computed.


RESULTS
Of the ProFiL pharmacists, 84% attended the workshop; their knowledge increased from 52% to 88% (95% CI: 29-40%). Most ProFiL pharmacists rated workshop (95%), communication program (82%) and consultation service (59%) as "excellent" or "very good"; 82% said the program improved the quality of their follow-up. The consultation service received 21 requests. ProFiL and usual care pharmacists issued a mean of 0.50 and 0.02 opinion/patient, respectively, (95% CI of the adjusted difference: 0.28-1.01 opinion/patient).


CONCLUSIONS
The results of this pilot study suggest that ProFiL can be implemented and may help community pharmacists intervene more frequently to manage drug-related problems. However, a larger-scale study with longer follow-up is necessary to evaluate the impact of the program on management of drug-related problems and its clinical relevance.
Lalonde
Lyne
L
Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada. lyne.lalonde@umontreal.ca
Normandeau
Michelle
M
Lamarre
Diane
D
Lord
Anne
A
Berbiche
Djamal
D
Corneille
Louise
L
Prud'homme
Louis
L
Laliberté
Marie-Claude
MC
D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D003142:Communication; D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000592:standards; D064420:Drug-Related Side Effects and Adverse Reactions; D004513:Education, Pharmacy, Continuing; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007674:Kidney Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010595:Pharmacists / Q000458:organization & administration* / Q000523:psychology / Q000592:standards; D010865:Pilot Projects; D024382:Professional Role; D011785:Quality Assurance, Health Care / Q000379:methods; D012017:Referral and Consultation