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WHAT PATIENTS WANT FROM A PHARMACY-LED MEDICINES MANAGEMENT SERVICE
Tinelli M, Jaffray M, Bond C, Watson M
on the behalf of Community Pharmacy Medicines Management Evaluation Team
Department of General Practice and Primary Care, University of Aberdeen, Westburn Road, Aberdeen, AB25 2AY
c.m.bond@abdn.ac.uk


Introduction
Recent policy developments include an increased role for the community pharmacist in the management of drug therapy in primary care1,2. In such service re-design, it is increasingly recognised that patient expectations and experiences must be considered. The Community Pharmacy Medicines Management Project3 was a large randomised controlled trial (RCT) to evaluate the introduction of a medicines management service by community pharmacists for patients with coronary heart disease (CHD). The RCT included an assessment of patients’ experiences and expectations using interviews and questionnaires. A subset of the results of the baseline and follow up questionnaires are reported here.

Methods
The questionnaire was developed, based on a literature review and previous patient questionnaires used by the authors. The survey included items on demography, experiences, and a series of statements asking patients what they would like to happen when they visited the pharmacy to collect prescribed medicines. Experiences of, and satisfaction with, the medicines management service per se were also included at follow-up. Subjects were mailed a questionnaire with a covering letter and a reply-paid envelope. Reminders were sent two weeks after the initial mailing. The survey was completed at baseline (pre-intervention) and follow-up (12 months post-intervention). The returned questionnaires were optically scanned into SPSS v11.5. The section on patients’ preferences on what they would like to happen when they visit the pharmacy for prescription medicines were analysed using a factor analysis with varimax rotation to identify any underlying main domains. The internal reliability of the scales developed from these factors was assessed using Cronbach’s α statistic. Only these data are reported here.

Results
At baseline, 1364 of 1441 questionnaires (intervention and control) (95%) were returned. At follow-up, 1153 of 1355 questionnaires (85%) were returned. At baseline, most respondents were aged over 65 years (76%), male (69%), retired (71%) and white (100%). Factor analysis of the intervention group at baseline identified three domains of patients’ preferences. The first domain (16 items) included medicines review jointly from the doctor and the pharmacist (68%), advice on effectiveness and safety of medicines (50-92%), privacy (54%), short waiting times (80%), closer partnership and communication with the pharmacist (63-92%). This first domain appeared to be more important to patients than the second domain (two items), which covered general lifestyle issues and specific health problems (58-61%). There was least support for the third domain (one item), which was for the pharmacist solely to retain their traditional supply function (21%). Similar findings were shown between groups across time.

Conclusion
The exploration of patients’ expressed preferences regarding their visit to the pharmacist covered a wide range of aspects that should be included in a patient-centred approach to service re-design in primary care. A community pharmacy-led medicines management service appears to meet the criteria required by patients for their preferred service.

References

  1. http://www.rpsgb.org.uk/nhsplan/medsman.htm (01/12/04)
  2. http://www.managingmedicines.com (01/12/04)
  3. http://www.medicinesmanagement.org.uk (01/12/04)

Presented at the HSRPP Conference 2005, Reading