Uptake of Community Pharmacist-Delivered MedsCheck Diabetes Medication Review Service in Ontario between 2010 and 2014.
OBJECTIVE
The objective of the study was to describe the demographic and clinical characteristics of MedsCheck Diabetes (MCD) recipients in Ontario between program launch on September 1, 2010, and March 31, 2014.


METHODS
This cohort study leveraged linked administrative claims data. Trends in MCD claims and recipient characteristics were examined.


RESULTS
A total of 406,694 Ontarians (45.8% women) received an MCD, representing approximately half of all Ontarians with diabetes. Recipients were more likely to be <66 years of age (54.6%), live in an urban centre (94.6%) and be native to Canada (81.0%). A total of 13,587 MCD follow ups were completed (4.1% of MCD recipients ≥66 years of age and 2.7% of MCD recipients <66 years of age). MCD recipients ≥66 years of age had received a mean of 11 unique prescription medications in the previous year, prior to receiving an MCD, and 12.9% had had high medication costs ($4000+) in the previous year. Metformin was dispensed to 76.4% of recipients, insulin to 20.1% and insulin secretagogues to 36.2%. The most common medication classes used by MCD recipients, other than antihyperglycemics, were antihypertensives (89.5%), antilipid therapies (83.8%), diuretics (52.1%), antibiotics (38.2%) and gastroprotective agents (34.9%). They were also taking high-risk medications, including narcotics (25.4%), anticoagulants (23.3%), nonsteroidal anti-inflammatory drugs (NSAIDs) (21.5%), benzodiazepines (15.5%) and glyburide (15.8%).


CONCLUSIONS
Over the first 3.5 years of the program, approximately half of Ontarians with diabetes received an MCD. Follow-up assessments were low (2.7% to 4.1% of the population). Ongoing evaluation of the program is required to ensure that continuity of care is being provided to this population.
Banting & Best Diabetes Centre, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada. Electronic address: lori.maccallum@uhnresearch.ca.
Lori
L
MacCallum
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
Giulia
G
Consiglio
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
Linda
L
MacKeigan
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada; Department of Family Medicine, Departments of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, Ontario, Canada; School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada; Centre for Evaluation of Medicines, St Joseph's Healthcare, Hamilton, Ontario, Canada.
Lisa
L
Dolovich
D000368:Aged; D015331:Cohort Studies; D003157:Community Pharmacy Services / Q000639:trends*; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000453:epidemiology*; D017723:Drug Utilization Review / Q000379:methods / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D059065:Medication Reconciliation / Q000379:methods / Q000639:trends; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010595:Pharmacists / Q000639:trends*
D007004:Hypoglycemic Agents
MedsCheck; Ontario; diabetes; diabète; pharmacien, pharmacienne; pharmacist; pharmacy service; service pharmaceutique