Community Pharmacists' Contribution to Medication Reviews for Older Adults: A Systematic Review.

OBJECTIVES: To identify medication review interventions for older adults that involve community pharmacists and evidence of outcomes of these interventions. DESIGN: Systematic review. MEASUREMENTS: Cinahl, MEDLINE (Ovid), Scopus, International Pharmaceutical Abstracts, and Cochrane Library were searched for articles published between January 2000 and February 2016. Articles involving community pharmacists in medication reviews for outpatients aged 65 and older were included. Evidence of economic, clinical, and humanistic outcomes of interventions was summarized. RESULTS: Sixteen articles were found that described 12 medication review interventions, of which 6 were compliance and concordance reviews, 4 were clinical medication reviews, and 2 were prescription reviews according to a previously developed typology. Community pharmacists' contributions to reviewing medications varied from sending the dispensing history to other healthcare providers to comprehensive involvement in medication management. The most commonly assessed outcomes of the interventions were medication changes leading to reduction in actual or potential drug-related problems (n=12) and improved adherence (n=5). CONCLUSION: Regardless of community pharmacists' contributions to interventions, medication review interventions seem to reduce drug-related problems and increase medication adherence. More well-designed, rigorous studies with more sensitive and specific outcomes measures need to be conducted to assess the effect of community pharmacists' contributions to reviewing medications and improving the health of older adults.

Email medication counseling services provided by Finnish community pharmacies.

BACKGROUND: The importance of email as a mode of communication between medication users and pharmacists is likely to increase. However, little is known about the email medication counseling practices of community pharmacies. OBJECTIVE: To determine the prevalence of email medication counseling services in Finland and to assess the accuracy and comprehensiveness of responses by pharmacies providing the opportunity for email medication counseling to inquiries related to use of antidepressants. METHODS: An inventory was made of all Finnish community pharmacies that provided the opportunity for email medication counseling. Data related to the accuracy and comprehensiveness of responses were collected, using a virtual pseudo-customer method with 3 scenarios related to common concerns of patients on antidepressants. Two inquiries were emailed to each pharmacy that provided the opportunity for email medication counseling in January and February 2005. The responses were content analyzed by 2 researchers, using a prestructured scoring system. RESULTS: Almost one-third (30%, n = 182) of Finnish community pharmacies maintained a working Web site, and 94% of those provided the opportunity for email medication counseling. An online "ask-the-pharmacist" service was offered by 13% (n = 23) of the pharmacies with a Web site. Pharmacies responded to 54% of the email inquiries sent by the virtual pseudo-customers. The response rate and the content score ratio between mean and maximum scores varied among the scenarios. The content score ratio was highest for the scenarios concerning the adverse effects of fluoxetine (0.53, n = 55) and interactions with mirtazapine (0.52, n = 63) and lowest for the scenario related to sexual dysfunction and weight gain associated with citalopram (0.38, n = 52). CONCLUSIONS: Community pharmacies are potential providers of email medication counseling services. However, more attention should be directed to responding to consumer inquiries and to the content of these responses.

Utilization of a community pharmacy-operated national drug information call center in Finland.

BACKGROUND: Provision of drug information has been identified as a key strategy to prevent adverse drug events; however, provision of drug information in face-to-face consultations between patients and health professionals is often suboptimal. OBJECTIVE: The objective of the study was to analyze and describe utilization of a community pharmacy-operated national drug information call center. The special focus was on calls concerning prescription drugs. METHOD: Trained pharmacists (n=20) recorded data from all telephone calls made to the Helsinki University Pharmacy drug information call center over a 1-week period by using a structured data collection instrument. Data of this cross-sectional study were quantitatively content-analyzed to compute descriptive statistics. RESULTS: Data were recorded for 2196 calls, 56% of which were drug-related. Of the drug-related calls, 79% were related to prescription drugs. The majority (83%) of these calls were therapeutic or pharmaceutical inquiries, with 26% concerning costs and reimbursements, 14% interactions, 14% dosages, and 11% adverse effects. Nervous system drugs (Anatomical Therapeutic Chemical [ATC] classification N), anti-infectives (J), and musculoskeletal drugs (M) accounted for 20%, 18%, and 13% of the calls, respectively. Nonsteroidal anti-inflammatory drugs (NSAID) (9% of the calls), antidepressants (6%), and penicillin (5%) were the most often inquired about ATC-subgroups. A majority (82%) of the callers were estimated to be between 20 and 60 years of age. CONCLUSION: Consumers appear to have multiple unmet drug information needs. This may especially be the case for certain population groups, and in regard to nervous system drugs, anti-infectives and NSAID. Drug information call centers operated by community pharmacies could complement face-to-face information provided by health professionals.