Impact of Community Pharmacist Interventions to Manage Medication Adherence
- Publication Type:
- Thesis
- Issue Date:
- 2021
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๐๐ฎ๐ฐ๐ธ๐ด๐ฟ๐ผ๐๐ป๐ฑ: As medication non-adherence continues to be a global public health problem, the development, evaluation and implementation of interventions to address this prevalent problem represent a key priority. Community pharmacistsโ role is evolving from the dispensing of medications to the provision of professional services aiming at improving patient outcomes. Pharmacists have, therefore, the potential to deliver interventions to manage medication adherence. Nonetheless, there is still a lack of evidence on the effect of community pharmacist-led interventions on medication adherence and clinical outcomes.
๐ข๐ฏ๐ท๐ฒ๐ฐ๐๐ถ๐๐ฒ๐: To explore and evaluate the impact of medication adherence interventions undertaken by community pharmacists across different chronic diseases. This research aims to provide evidence on the efficacy and effectiveness of community pharmacist-led interventions in Australia and Spain on medication adherence to interventions and disease-specific outcomes.
๐ ๐ฒ๐๐ต๐ผ๐ฑ๐: Multiple methods were applied in this research. Chapter 2 presents a systematic review and network meta-analysis, following the PRISMA guidelines, comparing long term interventions on the impact on medication adherence across different chronic diseases. Chapter 3 describes a retrospective observational study evaluating the impact of a real-life practice intervention in Australia provided by community pharmacist to patients with chronic medications (rosuvastatin, desvenlafaxine, irbesartan). Chapter 4 present a cRCT to evaluate the impact of a medication adherence management service in a community pharmacy setting in Spain. Chapter 5 describes a sub-analysis of the cRCT including patients with asthma and COPD being prescribed inhaled medications. A multilevel regression model was used to measure the impact of the medication adherence management service on medication adherence and disease-specific clinical outcomes (Chapter 4) and inhaler technique (Chapter 5). Chapter 6 presents an effectiveness-implementation hybrid design evaluating the clinical impact of the medication adherence management service when translated to routine practice during an implementation study. For this analysis, patients were classified in three groups: A) those allocated to the intervention group during the cRCT and continue during implementation, B) those allocated to the control group during the CRCT and continue during implementation, and C) new patients in the implementation study [โฆ]
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