Extending Medicines Management to Intermediate-Care Pharmacists

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TABLE OF CONTENTS

CHAPTER 1: INTRODUCTION1

Background1

The Change to Be Implemented1

The Rationale for Selecting the Change2

The Organizational Impact and Expected Outcome( s)3

The Potential Threats to Implementing the Change3

The Proposed Method(s) of Assessing the Change4

Summary4

CHAPTER 2: LITERATURE REVIEW5

Role Expansion of Pharmacists5

Pharmacists' roles on professional services related to medicine management10

Barriers to provide professional services concerning medicine managament11

Factors associated with pharmacists' professional roles on HDS14

Self-Efficacy of medicine management18

Interrelationships of factors associated with pharmacist's medicine management19

Medicine management and pharmacist21

REFERENCES24

CHAPTER 1: INTRODUCTION

Background

Community pharmacies are rapidly becoming useful centers for not only advising the community on healthy living but also integral parts of intermediate care. According to the National Prescribing Centre (NPC) (2008), community pharmacies are very effective avenues of improving patients' understanding about their medications. Established intermediate care pharmacies are potentially beneficial to the elderly and those living with long-term chronic conditions, which require constant medication and clinical close watch. Therefore, medications for patients with repeated prescriptions can be managed effectively by qualified intermediate care pharmacists at community care setting (Abarca Wang, Malone, Murphy and Armstrong 2006; 389).

The Change to Be Implemented

Extending medicines management to intermediate-care pharmacists is likely to impact positively in patients' who are on repeated medications. Given that, such patients are required to visit the hospital frequently for their continual prescriptions, there is a need for delegating this task to qualified pharmacists at community care setting to execute the roles of intermediate care pharmacists. However, proper coordination must be established between the involved intermediate care pharmacists and the hospital physicians to address any medical issues, which are of emergency.

The Rationale for Selecting the Change

Taking into consideration, the difficulties involved in accessing healthcare facilities, especially for patients with chronic and complex illness including the elderly and those recovering from acute illnesses; it is possible to manage such patients effectively in their respective intermediate care setting, without necessarily visiting the hospital regularly.

The NPC (2008) considers intermediate care pharmacists as avenues for not only moving healthcare services closer to patients but also for personalizing medicine management to meet the various healthcare needs for all patients. Effective medicines management through intermediate care pharmacists should help improve patients' adherence to their respective medications and enhance their independent living.

The NHS Innovations South East (2009) points out that; considerable amounts of prescribed medicines go to waste each year due to various reasons. First, it identifies the problem as consisting of confusion amongst patients who are unsure on how to take their medication resulting to non-compliance to treatment regimens. On the same note, confused patients are at risk of over-ordering drugs leading to either polypharmacy, which is dangerous or stockpiling of medications, which are eventually discarded. Secondly, some patients are unable to safely "unscrew lids on bottles or open foil packs" which often lead to premature expiry of drugs. Finally, most patients with frequent journeys are at risk of non -adherence to medications, for the reason that they often fail to carry with them all the prescribed medications ...