ABSTRACT
BACKGROUND: Pharmaceutical care (PC) services are increasingly provided in community pharmacies in the western world. Evaluations are often conducted as trials in highly controlled conditions measuring the efficacy of the service in terms of the economical, clinical and humanistic outcomes. Little is known about the real world provision of PC services and the factors associated with follow-up. OBJECTIVE: To characterize patients receiving a PC service, to explore factors associated with follow-up evaluations, and to describe the results of pharmacists' interventions. METHODS: A non-experimental, retrospective study using the Swedish national patient medication records data base. Patients receiving follow-up evaluations or one consultation within the service were compared using logistic regression. RESULTS: A total of 3298 patients received the PC service at 240 community pharmacies. Patient characteristics included: 66.3% female, mean age 71.1 years, mean number of prescription drugs used 10.5, with 86.2% of patients using >or=1 cardiovascular drugs. A quarter (25.8%) of patients had >or=1 drug-related problems, most commonly side effects. Follow-up evaluations were carried out for 46.6% of the patients, who were more likely to use a compliance aid. Patients receiving the PC service at pharmacies that had enrolled more than the mean number of patients (13.7) had twice as high a chance of receiving follow-up than those registered with pharmacies with fewer patients (i.e. below the mean) enrolled. Followed-up interventions led to a better perceived outcome in 46.3% of cases, no change in 48.5% and a worse outcome in 5.2%. CONCLUSIONS: This study demonstrates that the total number of patients enrolled in a PC service predicts whether follow-up evaluations will take place or not more than do patient characteristics.
Subject(s)
Community Pharmacy Services/organization & administration , Directive Counseling/organization & administration , Pharmacists/organization & administration , Aged , Aged, 80 and over , Databases, Factual , Drug-Related Side Effects and Adverse Reactions , Female , Follow-Up Studies , Humans , Logistic Models , Male , Medication Adherence , Middle Aged , Professional Role , Retrospective Studies , SwedenABSTRACT
Computer administrered QoL instruments are increasingly used to assess outcomes. Our aim was to assess the feasibility and validity of an electronic version of the SEIQoL-DW. Pharmacy students (n = 40; mean age 25; 92% women) were administrated both the touch screen and the paper-and-pen versions in a cross-over study. The majority of the students (65 %) preferred the computer version, while almost a third (27%) preferred the paper and pen version. There was no overall order effect and the SEOQoL-DW index mean scores differed with 1.2 between the two versions. Those respondents completing the computer version first had higher scores than those completing the computer version second. The ICC comparing the formats was 0.77 (CI: 0.57-0.88) and the limits of agreement method showed that 85% of the observations were within +/- 1-10 units. Most students (82%) judged their QoL as being equivalent to their SEIQoL-DW score. The computer version of the SEIQoL-DW seems to be feasible and acceptable and seems to be valid alternative to the paper and pen version. However, further validation studies in larger patient populations are needed.
