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Community Pharmacist and General Practitioner Collaborated Health Care Services - a Review Jaidev Kumar, Kotyal Basvannappa Mahendrappa*, Pramod Kumar, U

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Community Pharmacist and General Practitioner Collaborated Health Care Services - a Review Jaidev Kumar, Kotyal Basvannappa Mahendrappa*, Pramod Kumar, U Review Article Community Pharmacist and General Practitioner Collaborated Health Care Services - A Review Jaidev Kumar, Kotyal Basvannappa Mahendrappa*, Pramod Kumar, U. R. Rakshith ABSTRACT Home medicines review (HMR) services were specifically created to assist elderly patients residing in their homes to have more benefits of medication regimen that can help them in understanding the importance of medications through medication review by community pharmacist and HMR services were rendered with the intention of minimizing medication-related problems. The successful operation of HMR depends on good coordination between patients, general practitioner (GP), and accredited pharmacist. In some circumstances, other health-care team members such as nurses in community practice can also play an important role in ensuring whether patient is following correct administration guidelines of medicine or not. The common screening of medications carried out by community pharmacist was reflected with checking rationality of drug, over the counter medicinal products, patient medication adherence, drug therapy monitoring whether signs and symptoms are minimized or subsided. If drug-related problems were identified they were communicated to concerned patient consultant through HMR report and requested to make certain changes in drug therapy management in according to severity of drug- related problem. KEY WORDS: Home, Medicine, Review INTRODUCTION improved medication adherence due to comprehensive pharmaceutical care services provided during HMR One of the research investigator named Urbis Keys study. Young 2005 showed that the application of home medicines review (HMR) services was responsible ADHERENCE/COMPLIANCE/ for bringing down the number of hospital admissions which was reflected by HMR data of patients. Another CONCORDANCE research study known as VALMER study (Stafford) The medication adherence during randomized which was carried out in 2012 reflected that HMR controlled trial of HMR in Australia was assessed with was responsible or influential in bringing down the application of two self-administered questionnaires. duration of hospital stay during 1 year and enabled to The findings of medication adherence among test and resolve the identified drug-related problems (DRPs) control group did not show any significant difference by pharmacists. Older HMR research studies carried and reflected overall high levels of adherence rate at out in Australia, UK, Canada, etc., have clearly reflected that pharmacist can play an important role all-time follow-up of patients in both groups. HMR in minimizing DRPs among patients prescribed research studies that were carried out in medication with polypharmacy. HMR services received among adherence showed that good progress in medication patients with complicated medical problems have adherence did not mean that it can have impact on health shown that pharmacist can play important role in outcomes of patients. Therefore, assessing medication minimizing drug-induced hospitalization followed by adherence with respect to medical conditions does mean that there is only clinical endpoint outcome. The Access this article online concrete evidence regarding medication adherence of HMR is lacking due to inadequate research duration Website: jprsolutions.info ISSN: 0975-7619 and less sample size. Department of Paediatric, JSS Medical College and Hospital (Affiliated to JSS Academy of Higher Education and Research), Mysore, Karnataka, India *Corresponding author: Dr. Kotyal Basvannappa Mahendrappa, Department of Paediatric, JSS Medical College and Hospital (Affiliated to JSS Academy of Higher Education and Research), SS. Nagar, Mysore - 570 015, Karnataka, India. Mobile: +91-9448026099. E-mail: [email protected] Received on: 07-10-2019; Revised on: 11-11-2019; Accepted on: 14-12-2019 Drug Invention Today | Vol 14 • Issue 3 • 2020 377 Jaidev Kumar, et al. COORDINATION AMONG the research author suggests that frequent medication HEALTH-CARE TEAM reviews on ederly patients by research pharmacists can help in overcoming medication abuse. Implementation MEMBERS and evaluation of therapeutic guidelines will help in minimizing the inappropriate use of medications To achieve better patient health welfare good [5] coordination among health-care team members are among elderly patients. required, so health-care outcomes will be successful. A clinical trial study by Bernal et al. suggests that Patients who are recently discharged from hospital following therapeutic guidelines (i.e., antithrombotic, can find more benefits by HMR services as per the [1] Beta-blockers, angiotensin-converting enzyme recommendations of Campbell research study. inhibitors, and statins) applied in the management of Lee et al. reflected in their research study that New acute coronary syndrome (ACS) have shown better [6] Zealand Pharmacists have provided medication prognosis. Research author also states that ACS reviews for selected patients for almost two decades patients have reflected further progression of disease by working with patient consultant for providing better and increased mortality rate due to inappropriate use health-care services that help to establish good rapport of medications. According to research author, one between patient and pharmacist.[2] Pharmaceutical of the important problems reflected in this study review services were government-funded in New was premature discontinuation of the medications Zealand where patient needs not bear any medication and non-adherence to medications in patients with expenses, whereas comprehensive pharmaceutical care ACS can lead to more health-care problems due to is not a government-funded health-care services and further progression of disease. Therefore, to overcome patient must bear medical expenses by themselves.[2] medication-related problem regular medication review by pharmacists in post-discharged patients with ACS Residential Medication Management Review can improve patient prognosis.[6] (RMMR) guidelines are the one which support the quality use of medicines, i.e., safe and effective use Holland et al. have reported that older people are often of medicines in respective medical conditions and acquired by multiple diseases for which they receive medication review services for aged patients with the multiple medications that can lead to complexities and assistance of accredited pharmacists.[3] Establishing drug toxicities which can be overcome by pharmacist this type of RMMR guidelines for residential aged medication review among these older patients. The patients in Australian study have reflected improved research carried out by pharmacist-led medication health-care outcomes.[3] review interventions should be based on the identified DRPs and assess whether medications were Turner and Bell research study reflected that medication responsible for hospitalization or mortality rate among review carried out by the health-care team consisting older patients. This research study finally concludes of pharmacists and general medical practitioners is a that pharmacist-led interventions in older patients broader investigated concept to get the most utility of may improve drug knowledge and drug adherence but medications. According to findings of research, author lack of information reveals that whether the patient different health-care benefits such as minimizing the quality of life was influenced positively on health-care adverse drug events (ADEs), physical verification of outcomes of older patients?[7] storage, and expiry date of medication, and compilation of medication list comprising of prescribed and non- Rigby suggests that role of pharmacists is broadening prescribed medications. The author finally concludes in primary health-care services. According to that ADEs are more in elderly patients due to age- this author, success in primary health care can be related pharmacokinetic changes, but the occurrence obtained with good coordination among health-care [8] of ADEs can be minimized by conducting more HMR professionals. A literature review by the national programs in the future in according to the clinical prescribing service of Australia has been able to situation of medical case.[4] identify more DRPs during medication misadventure which accounts nearly 6% of hospitalization due to Gowan and Roller study reflects elder drug abuse ADEs when it was compared with other categories mean misusing drugs such as deliberate consumption of medication errors such as underdose, overdose, of excessive quantity of the drug or not following and failure to receive medication. The important correct directions of drug usage.[5] Elderly abuse can reason behind influence of medication errors was poor occur in all cultures crosswise across all social and communication among the health-care professionals. economic classes due to imbalance thoughts of power. Research author suggests that medication-related Elderly patients suffering from chronic medical problems can be overcome with good coordination conditions can end up with poor prognosis due to among health-care professionals, i.e., doctors, nurses, multiple medications of irrational drug use. Therefore, and pharmacists.[8] 378 Drug Invention Today | Vol 14 • Issue 3 • 2020 Jaidev Kumar, et al. Zermansky et al. have said that elderly people are often electronic database as separate tool to monitor DRPs weak due to aging factor and can have progressive for clinical management of patients. The electronic degenerative health problems.[9] Increased
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