RESUMO
Background Medication safety and adherence are important aspects of quality of life, especially for frail elderly in our society. However, many elderly living at home may experience difficulties when taking their medication, and are therefore at risk for medication- related problems. The current living lab was implemented within the framework of the Flanders Care Living Labs and set the objective to develop a care pathway to improve medication safety and adherence for elderly living at home. Automated Individual Medication Preparation [IMP] was provided by a community-pharmacist in order to support frail elderly in taking their medication more correctly and thereby improving adherence. Methods In a before and after study, each patient was supported for 13 weeks through a multidisciplinary care pathway. Key in this pathway was the shared medication schedule (between GP and pharmacist) as the starting point for IMP and medication counselling. The increased medication support based on IMP was evaluated in frail elderly (age a 65 years, complex medication scheme a 5 medicines and a 3 intakes / day) before and after the study, by measuring adherence and satisfaction with counselling and repackaging the medication in sachets. Results The preliminary results of the current study showed that the self-reported adherence rate in frail elderly was significantly higher (p <0.05) after implementation of the pharmacists' intervention with automated IMP. At the end of the study every patient indicated that the repackaging of the medication by dose was helpful in order to take their medication correctly. Conclusion Increased medication counselling with IMP by the community-pharmacist may be a useful aid and supporting tool for frail elderly living at home with a complex medication scheme.
Assuntos
Aconselhamento , Conduta do Tratamento Medicamentoso , Idoso , Idoso de 80 Anos ou mais , Serviços Comunitários de Farmácia , Humanos , Adesão à Medicação , FarmacêuticosRESUMO
Vitalink is a digital platform to share health patient data among health care professionals in primary care. The Flemish community started the development of this platform in collaboration with representatives of professional associations primary care. Sharing medication charts online was the first Vitalink project. In December 2012 four pilot regions in Flanders (Turnhout, Limburg, Aalst and Halle) tested medication chart sharing through Vitalink. Due to difficulties with software development effective sharing started only in April 2013. The test phase was ended in October 2013. Each pilot region made an evaluation report. Conclusions were similar: the realization business cases were limited. Integration in end user software was insufficiently performant. Moreover, interpretation of downloaded medication charts was found out to differ among participating software applications. Because of these problems exchange of patient records among primary care actors was limited. Therefore research questions could not be conclusively answered. Nevertheless the Vitalink pilot project can be considered successful in some ways. Collaboration and communication among health care professionals and their associations was ameliorated. The awareness of digital data sharing in primary care is growing. Pilot projects created buy in among patients, physicians, pharmacists and nurses. Uniform lay-out guidelines were established in deliberation with all participating actors. Since November 2013 Vitalink is in production. Medication charts, summarized electronic health records and vaccination data can be uploaded to the platform and health care professionals that are registered can consult them. End user software must still be developed to make broad use of the platform feasible. Meanwhile further deliberation with software vendors and professional associations can be organized in order to achieve the implementation and integration of user friendly Vitalink modules.
