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Improving the well-being of elderly patients via community pharmacy based pharmaceutical care


- To develop a standardised community pharmacy based pharmaceutical care programme (education and monitoring) for the prevention of drug related problems in elderly patients
- To evaluate, in a controlled multicentre trial in several EU countries, the outcome of the interventions on the quality of care (including health related quality of life) of a targeted group of "at risk" elderly patients and on the costs of their healthcare.

Pharmaceutical Care is a new approach to the delivery of pharmaceutical services to patients. It involves the active participation of the pharmacist in the treatment of the patient through involvement in structured education and monitoring activities. The overall aim of "Pharmaceutical Care" is to decrease the number of drug related problems experienced by patients and thereby improve their quality of life. It has been well established that elderly patients (65 years+) are more likely to suffer from chronic illness than their younger counterparts, receive a disproportionate number of medicines and therefore suffer from a greater number of drug related problems. The aim of the present study is to evaluate, in a multicentre international investigation within the EU, the benefits and cost-effectiveness of a harmonised, structured community pharmacy based intervention programme to improve the care of elderly patients. It is hypothesised that improved pharmaceutical care of elderly patients can help prevent serious drug related problems arising and could therefore save considerable sums of money as well as improving the quality of life of these patients. The study will be carried out in seven EU countries and will involve a minimum of 12 pharmacies (half control sites and half intervention sites) per country and a minimum of 40 patients per pharmacy will be enrolled into the study. Pharmacists will be encouraged to liaise with other primary healthcare workers, e.g. general medical practitioners (GPs) and community nurses, during the study.

The project will run over a period of three years and will involve: Development of a manual of structured pharmacy interventions for elderly patients e.g. strategies for patient education on the safe and effective use of their medicines. Identification of patients at increased risk using simple selection criteria e.g. >65 years old and receiving five or more allopathic prescribed drugs. Carrying out the structured interventions in the targeted group in a controlled clinical study. Measurement of the impact of the interventions on the quality of care of the targeted patient group and on the cost of their healthcare provision Harmonisation of the approach will be assured via the use of (after translation into the local language) the same care strategies, education materials and monitoring procedures (manual) in each participating centre. Results will be analysed at the local level, but more importantly the results from the different countries will be pooled and reanalysed. The latter will not only allow for a greater statistical power but will also allow comparison of data from different countries in a multivariate analysis. The reasons for any significant differences between countries will be sought through careful examination of the differences in national community pharmacy practice. Communication of the results to national Health Departments, as research papers and presentations at international meetings and through an established networks (e.g. Europharm Forum) will help ensure that best examples of practice are considered and adopted across the EU.


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