Abstract
Background
Since 2010, Swiss pharmacists have been offering their patients a Polymedication Check (PMC), a new cognitive pharmacy service in the form of a medication review for patients taking ≥4 prescribed medicines for a period >3 months. While a first publication of this project reported on the impact of the PMC on patients’ adherence, the present paper focuses on humanistic outcomes.
Methods
This randomized controlled trial was conducted in 54 Swiss community pharmacies. After recruitment, the intervention group underwent a PMC in the pharmacy (T-0) and 28 weeks after T-0 (T-28), while the control group did not receive the PMC until 28 weeks after the study started (T-28). A clinical psychologist, blinded to the intervention, interviewed the patients 2 weeks (T-2) and 16 weeks (T-16) after T-0. Interviewer and patient both rated patient’s knowledge of own medicines use. Furthermore, patients reported satisfaction with their pharmacy and appraisal of their medicines use. The availability of a written medication plan was assessed at T-16. Acceptance of the service was measured using a patient’s self-report questionnaire at T-28.
Results
General linear model analysis for knowledge about medicines revealed a significant effect on the factor “group” (P=5.86, p=0.016), indicating that the intervention group had higher ratings for knowledge about their medication at T-2 and T-16 compared to controls. The majority (83%) of patients judged the counseling by the pharmacist as being helpful for their daily medication management. Availability of a written medication plan was comparable in both groups (52.5% vs 52.7%, p>0.05).
Conclusion
For the first time, the benefits of a complex pharmacist-led intervention were evaluated in Swiss primary care with a randomized controlled trial. The PMC increased patients’ subjective knowledge of their medicines compared to no medication review. The effect remained sustainable over time. Recommendations resulting from the pharmacist-led service were highly appreciated by the patients.
Acknowledgments
We thank all participating patients, all involved study pharmacists, and all contributors in the study team (namely the telephone interviewers Verena Ehrbar, Kathrin Frehner, and Sophie Müller-Siemens). We are further grateful to William Caddy for proofreading the final manuscript. The study was developed as an investigator-initiated project and partly funded by the Swiss pharmacists’ association, pharmaSuisse. The funders had no role in the design, conduct, analyses or writing of this study or in the decision to submit for publication.
Author contributions
All the authors have full access to all the data (including statistical reports and tables) in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. MM and KEH conceived the trial design and wrote the ethical proposal and study protocol. NV helped in developing the measurement tools (namely designing, piloting, and supervising the telephone interviews) and ensured independent training and support of the involved staff. As the main investigator, MM recruited and coordinated the study pharmacists and their patients and ensured compliance to study protocol. MM and NV accessed and analyzed the retrieved data. MM prepared the draft of a first report, while KEH and NV contributed to the discussion and revised the manuscript. They all read and approved the final version to be published.
Disclosure
The authors report no other conflicts of interest in this work.