Ontario’s MedsCheck and Pharmaceutical Opinion Programs fund community pharmacist services intended to enhance the use and prescribing of medications.
MedsCheck is a one-on-one meeting between patients and their pharmacists to review medications and help patients better understand their medication therapy and how to take their drugs. A Pharmaceutical Opinion is a pharmacist recommendation to a prescriber regarding a potential problem that the pharmacist has identified with a patient’s medication.
Led by Linda MacKeigan at the University of Toronto and Lisa Dolovich at McMaster University, this project entails a comprehensive analysis of the MedsCheck Annual, MedsCheck Diabetes and Pharmaceutical Opinion Programs.
The team is using research methods that span many avenues of discovery including analysis of Ministry of Health and Long-term Care administrative data, analysis of pharmacies’ documentation of the services, as well as interviews and surveys of key stakeholder groups including pharmacy corporate executives, pharmacists, physicians and patients.
“Our key informant interviews with pharmacy managers and corporate executives have revealed that implementation strategies have focused on supporting and motivating pharmacists to perform more MedsChecks. Much less attention has been paid to quality,” Dr. MacKeigan said. “A commonly held belief was that quality was up to the discretion of the individual pharmacist.”
Similarly, over time MedsCheck services are being provided to less complicated patients, she said.
The team’s research to date has also shown that three-quarters of pharmaceutical opinions provided by pharmacists have resulted in medication changes that the prescriber supports.
“This finding demonstrates the value of this service to physicians and what community pharmacists can achieve when operating at a fuller scope of practice,” Dr. Dolovich said.
Combined with results in the project’s third year, these findings will provide a clearer picture of MedsCheck and Pharmaceutical Opinion service delivery, patient characteristics, and areas of program strength and weakness so community pharmacist services can better meet patient needs and provincial priorities.
“Pharmacy is in a period of immense change and learning as the profession shifts to provide expanded professional services. We know that continuous quality improvement is necessary, especially in a time of overall healthcare transformation tempered by fiscal restraint,” said Dr. Dolovich.
“Armed with the project’s findings, pharmacy resources can be directed strategically to improve service quality, patient outcomes and cost effectiveness.”