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Implementation and evaluation of a home pharmaceutical care model through Telepharmacy
Cristina Villanueva-Bueno1, Roberto Collado-Borrell2, Carmen Guadalupe Rodríguez-González3
1Servicio de Farmacia, Hospital General Universitario Gregorio Marañón, Madrid. Spain. Instituto de Investigación Sanitaria Gregorio Marañón. Madrid. cvillanuevab@salud.madrid.org.
Objective:
To describe the impact of a Specialized Pharmaceutical Care model that includes pharmacotherapeutic monitoring of patients through an Telepharmacy platform and home medication dispensing.
Method:
A descriptive and retrospective study conducted in the Pharmacy Service of a tertiary hospital, between 23 March 2020 and 31 December 2021. A new pharmaceutical care model for chronic ambulatory patients was developed, including: (i) definition of criteria for selecting Telepharmacy candidate patients; (ii) stratification of patients by risk level; (iii) definition of individualized pharmacotherapeutic monitoring; (iv) adaptation of the Pharmacy Service app platform to ensure continuous pharmacotherapeutic monitoring and patient monitoring (e- Oncohealth, e-Midcare and farMcuida), (v) implementation of an appointment system; and (vi) development of a software module for the management of home medication delivery. The impact of this pharmaceutical care model was assessed by analyzing indicators of activity, safety, adherence and perceived quality. Moreover, an additional study on the impact of COVID‑19 was developed in order to assess the accessibility of medical care and continuity of treatment through a survey conducted on a random sample of 100 patients.
Results:
During the study period, 2,737 patients benefited from the new remote pharmaceutical care model. A total of 7,758 Telepharmacy consultations were performed. Pharmacotherapeutic monitoring prevented 1,043 adverse drug reactions, which affected 10.4% of patients (3.6 adverse drug reactions/patient). Mean adherence to treatment was 95.2%. Overall satisfaction with the new model was 9.8/10. All patients would recommend this model to other patients.
Conclusions:
The new Pharmaceutical care model increases patient safety and improves treatment adherence, with a high perceived quality. Patient stratification and individualized follow-up via an Telepharmacy platform were crucial to the development of this model.
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