Medication Management Program: Clinical Pharmacy on the Front Lines

Andrea Cartwright

Abstract


The Medication Management Program (MMP) has been delivering community-based clinical pharmacy services to residents in Fraser Health (FH) since April 2005.  There are currently four full time clinical pharmacists working out of Home Health offices in six areas of FH: Surrey, Burnaby, TriCities, New Westminster, Abbotsford, South Surrey/White Rock).  These pharmacists visit patients in their homes to assess their medication-related needs. Eligible patients include those 65 years of age or older who have been recently discharged from hospital on at least 6 regularly scheduled medications.  Additionally, any health care professional, such as physicians, Home Health staff (e.g. nurses, case managers, allied health professionals) and hospital staff (e.g. Home Health liaisons, pharmacists) can refer patients to the MMP.

The basis of this program was a randomized controlled trial done in White Rock, BC that demonstrated a pharmacist and nurse home visit to high risk seniors after discharge from hospital resulted in reduced subsequent hospital days and stays and a net reduction in costs. (1) An economic evaluation of the first two years of the MMP demonstrated that patients who received the service had lower subsequent health resource utilization (reduced hospital days and stays with associated significant cost savings) in the year after receiving the service compared with the year prior. (2)  A survey to evaluate patient satisfaction with the program has been undertaken.

The value of this program reaches far beyond its financial implications to the clinical endpoint of ensuring patients receive rational, effective, safe, and accessible drug therapy.  In this workplace spotlight, we will outline the daily activities of a medication management program pharmacist, provide examples of interventions made by these pharmacists and illustrate the duties, challenges, and opportunities of this unique practice setting.

 

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Keywords


clinical community pharmacists

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References


REFERENCES

McGowan P, Green L, Beattie BL, Chappell N, Clarke H, Gayton D, et al. High-risk patient intervention program. Summary of evaluation results. Vancouver [BC]: University of British Columbia, Institute of Health Promotion Research; 2001. Unpublished.

Flanagan PS, Virani A, Baker W, Roelants H. Pharmacists Making House Calls: Innovative Role or Overkill? Can J Hosp Pharm. 2010;63(6):412-419.

Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998 Sep 12;352(9131):854-65. Erratum

Holman R, Sanjoy P, Bethel MA, Matthews D, Neil A. 10-year follow-up of intensive glucose control in type 2 diabetes (UKPDS 80). N Engl J Med. 2008;359:1-13

Flanagan PS, Pawluk S, Bains S. Opportunities for medication-related support after discharge from hospital. Can Pharm J. 2010;143(4):170-75.