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Improving the Well-Being of Elderly Patients via Community Pharmacy-Based Provision of Pharmaceutical Care

A Multicentre Study in Seven European Countries

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Abstract

Objective

This study aimed to measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients (≥65 years of age) by community pharmacists in a multicentre international study performed in 7 European countries.

Design and setting

The study was a randomised, controlled, longitudinal, clinical trial with repeated measures performed over an 18-month period. A total of 104 intervention and 86 control pharmacy sites participated in the research and 1290 intervention patients and 1164 control patients were recruited into the study.

Main outcome measures and results

A general decline in health-related quality of life over time was observed in the pooled data; however, significant improvements were achieved in patients involved in the pharmaceutical care programme in some countries. Intervention patients reported better control of their medical conditions as a result of the study and cost savings associated with pharmaceutical care provision were observed in most countries. The new structured service was well accepted by intervention patients and patient satisfaction with the services improved during the study. The pharmacists involved in providing pharmaceutical care had a positive opinion on the new approach, as did the majority of general practitioners surveyed. The positive effects appear to have been achieved via social and psychosocial aspects of the intervention, such as the increased support provided by community pharmacists, rather than via biomedical mechanisms.

Conclusions

This study is the first large-scale, multicentre study to investigate the effects of pharmaceutical care provision by community pharmacists to elderly patients. Future research methodology and implementation will be informed by the experience gained from this challenging trial.

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Acknowledgements

We acknowledge the European Commission, under the BIOMED 2 programme for medical research, for funding the coordination of the multicentre study. The following groups are also thanked for their financial and/or logistical support in the respective countries: Northern Pharmacies Trust (Northern Ireland); Apotekerfonden of 1991, The Association of Danish Pharmacists Development Fund, Danish Pharmacy Assistants Association (Denmark); Administração Regional de Saúde do Centro, Departmento de Estudos e Planeamento da Saúde — Direccção Geral da Saúde and Instituto Nacional da Farmácia e do Medicamento, Departments of the Health Ministry (Portugal); KNMP — The Royal Dutch Association for the Advancement of Pharmacy, OPG, Brocacef and Interpharm (wholesale companies) and the Stichting Pharmaceutical Care (Pharmaceutical Care Foundation) [The Netherlands]; The Pharmacoepidemiology Fund (Republic of Ireland); Apotekerkammer Westfalen-Lippe, Arz Haan and ABDATA Eschborn (Germany); and Apoteket AB (National Pharmacy Company) and the National Board of Health and Welfare (Sweden).

Thanks are also due to all community pharmacists, other primary healthcare staff and the patients who participated in the research project in their respective countries. We would like to acknowledge the statistical support of Dr Gordon Cran and Dr Derrick Bennett.

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Authors and Affiliations

  1. Socialstyrelsen, Stockholm, Sweden

    Cecilia Bernsten

  2. Apoteket AB, Sektor Farmaci, Stockholm, Sweden

    Ingeborg Björkman & Erika Grundberger

  3. Faculdade de Farmacia, Laboratorio de Farmacologia, University of Coimbra, Coimbra, Portugal

    Margarida Caramona & Sonia Silva

  4. Pharmacy Practice Research Group, The School of Pharmacy, The Queen’s University of Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland

    Grainne Crealey, Carmel Hughes,  James McElnay & Ian Sturgess

  5. Pharmakon, Danish College of Pharmacy Practice, Hillerød, Denmark

    Bente Frøkjær, Tove Gustafsson, Hanne Herborg & Birthe Søndergaard

  6. School of Pharmacy, Trinity College, Dublin, Republic of Ireland

    Martin Henman, Maeve Magner & Lisa Vivero

  7. Subfaculteit Farmacie, Werkgroep Social Farmacie en Farmacopidemiologie, Rijksuniversiteit Groningen, Groningen, The Netherlands

    Foppe van Mil & Dick Tromp

  8. Fachbereich Pharmazie, Humboldt University Berlin, Berlin, Germany

    Marion Schaeffer & Almut Winterstein

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  1. Cecilia Bernsten
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  2. Ingeborg Björkman
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  3. Margarida Caramona
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  9. Hanne Herborg
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  10. Carmel Hughes
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  11. James McElnay
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  14. Marion Schaeffer
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  15. Sonia Silva
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  16. Birthe Søndergaard
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Bernsten, C., Björkman, I., Caramona, M. et al. Improving the Well-Being of Elderly Patients via Community Pharmacy-Based Provision of Pharmaceutical Care. Drugs & Aging 18, 63–77 (2001). https://doi.org/10.2165/00002512-200118010-00005

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