Community pharmacist-led interventions and their impact on patients’ medication adherence and other health outcomes: a systematic review

IntroductionMedication adherence can be defined as the extent to which one’s medication‐taking behaviour follows that mutually agreed upon by the prescribing physician. Optimal medication adherence is often deemed crucial for the success of a patient's treatment, as suboptimal adherence may lead to treatment failure and unnecessary medical expenditure. Increasing evidence has highlighted the positive contribution community pharmacist‐led interventions can have on improving patients’ adherence and health outcomes.ObjectivesTo provide an overview of the published literature on community pharmacist‐led interventions and their effectiveness in improving patients’ adherence and health outcomes.MethodsA search strategy was developed, aiming to retrieve published reports of community pharmacy interventions worldwide. Medline, EMBASE, International Pharmaceutical Abstracts, Google Scholar and ProQuest Dissertations and Theses databases were searched. Articles meeting the inclusion criteria were collated, relevant data extracted, and a risk of bias assessment undertaken.Key FindingsTwenty‐two studies were included in the analysis, and their outcomes were reported in 26 peer‐reviewed journal articles. Community pharmacist‐led interventions have been shown to improve patients’ adherence and contribute to better blood pressure control, cholesterol management, chronic obstructive pulmonary disease and asthma control. Studies in this review, however, did not report statistically significant effects of interventions on diabetes or depression control.ConclusionCommunity pharmacist‐led interventions have been shown to contribute to improved adherence and better disease control. Future research should attempt to better understand which particular intervention components make the greatest contribution towards improving adherence and health outcomes, for patients with different medical conditions

Why do pharmacists leave the profession? A mixed-method exploratory study

Background : Recent New Zealand policy documents aim for pharmacists to be retained , and promote the provision of extended clinical pharmacy services. However, younger pharmacists have expressed dissatisfaction with the profession on informal s ocial for a. Objectives : To explore the characteristics, and perspectives of pharmacy as a career, of recent Bachelor of Pharmacy (BPharm, four - year degree) graduates who have left, or are seriously considering leaving the New Zealand pharmacy profession i n the near future and where they have gone, or plan to go. Methods : We conducted a cross - sectional study with a mixed - method explanatory sequential design. An anonymous online survey among those who completed their pharmacy undergraduate degree (BPharm or equivalent) in 2003 or later and who had left or who were seriously considering leaving the New Zealand pharmacy profession in the next five years, was open from 1 st December 2018 to 1 st February 2019. Recruitment occurred via University alumni databases, pharmacy professional organisations, pharmaceutical print media, social media and word - of - mouth. Ten semi - structured interviews were then conducted with a purposive sample of survey respondents. Descriptive statistics were generated from the quantitative d ata and qualitative data were analysed using manifest content analysis. Results : We received 32 7 analysable surveys of which 40. 4 % (n=132) were from those who had already left the New Zealand pharmacy sector at the time of the data collection and the rest ( 59.6% n=19 5 ) were those working within the sector, but seriously considering leaving the profession. Reasons most commonly reported for studying pharmacy were having an interest in health and wanting to work with people. The most common reasons for leavin g, or wanting to leave, were dissatisfaction with the professional environment, including inadequate remuneration, and a perceived lack of career pathways or promotion opportunities. A wide range of career destinations were declared, with medicine being mo st frequently reported. Conclusions : Most of the reasons for leaving/considering leaving the profession reported relate to the values and features of the pharmacy profession such as the professional environment, remuneration and career pathways. These find ings are consistent with other studies and may represent a barrier to achieving the aims of recent health policy docu

Additional file 1: of Prescription medicine sharing: exploring patients’ beliefs and experiences

Interview guide. (DOCX 17 kb

Understanding barriers to optimal medication management for those requiring long-term dialysis: Rationale and design for an observational study, and a quantitative description of study variables and data

Background: Rates of medication non-adherence in dialysis patients are high, and improving adherence is likely to improve outcomes. Few data are available regarding factors associated with medication adherence in dialysis patients, and these data are needed to inform effective intervention strategies. Methods/design: This is an observational cross-sectional study of a multi-ethnic dialysis cohort from New Zealand, with the main data collection tool being an interviewer-assisted survey. A total of 100 participants were randomly sampled from a single centre, with selection stratified by ethnicity and dialysis modality (facility versus home). The main outcome measure is self-reported medication adherence using the Morisky 8-Item Medication Adherence Scale (MMAS-8). Study data include demographic, clinical, social and psychometric characteristics, the latter being constructs of health literacy, medication knowledge, beliefs about medications, and illness perceptions. Psychometric constructs were assessed through the following survey instruments; health literacy screening questions, the Medication Knowledge Evaluation Tool (Okuyan et al.), the Beliefs about Medication Questionnaire (Horne et al.), the Brief Illness Perception Questionnaire (Broadbent et al.). Using the study data, reliability analysis for internal consistency is satisfactory for the scales evaluating health literacy, medication knowledge, and beliefs about medications, with Chronbach's α > 0.7 for all. Reliability analysis indicated poor internal consistency for scales relating to illness perceptions. MMAS-8 and all psychometric scores are normally distributed in the study data. Discussion: This study will provide important information on the factors involved in medication non-adherence in New Zealand dialysis patients. The resulting knowledge will inform long-term initiatives to reduce medication non-adherence in dialysis patients, and help ensure that they are addressing appropriate and evidence based targets for intervention