Impact of Pharmacists in a Community-Based Home Care Service: A Pilot Program

Area of Science:

• Health Services Research
• Pharmacy Practice
• Geriatric Medicine

Background:

• Home care patients frequently experience medication errors, yet pharmacists are often excluded from home care teams.
• Limited literature exists on Canadian pharmacy practice models in home care settings.
• Optimal service delivery and clinical activity distribution for home care pharmacists are not well-defined.

Purpose of the Study:

• To describe the impact of a pharmacist providing home visits, group education, and telephone consultations within a community home care office.
• To assess the utility of acute care clinical pharmacy key performance indicators (cpKPIs) for guiding home care pharmacy services.

Main Methods:

• A pilot program was implemented from May 2015 to July 2016 by the Winnipeg Regional Health Authority.
• A referral form based on primary care consultation criteria was developed.
• A pharmacist reviewed patient intakes and those awaiting home care admission to address medication issues proactively.

Main Results:

• 197 referrals (184 patients) were received; 62 were excluded. 70.4% of referrals were for medication reviews, identifying 271 drug therapy problems.
• Pharmacist recommendation acceptance rates were 90.2% among home care staff and 47.0% among prescribers/patients.
• An average of 1.5 clinical pharmacy key performance indicators (cpKPIs) were identified per referral.

Conclusions:

• The pilot program indicated a significant need for improved clinical pharmacy access for home care patients.
• The most effective service delivery model for home care pharmacy remains undetermined.
• Further research is necessary to establish optimal pharmacy services and relevant cpKPIs for home care.