Development and testing of a framework for defining a strategy to address medication adherence during patient encounters in community pharmacies

Pascal C Baumgartner; Nicolas Comment; Kurt E Hersberger; Isabelle Arnet

doi:10.1016/j.rcsop.2022.100123

Development and testing of a framework for defining a strategy to address medication adherence during patient encounters in community pharmacies

Explor Res Clin Soc Pharm. 2022 Mar 9:5:100123. doi: 10.1016/j.rcsop.2022.100123. eCollection 2022 Mar.

Authors

Pascal C Baumgartner¹, Nicolas Comment¹, Kurt E Hersberger¹, Isabelle Arnet¹

Affiliation

¹ Pharmaceutical Care Research Group, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland.

Abstract

Background: Counseling patients on medication adherence could be ameliorated in pharmacy practice. There is a lack of simple and practical strategies to address medication adherence with patients in daily practice. The goal was to develop and test a framework that allows pharmacy teams to define and apply a strategy to address medication adherence in community pharmacies.

Methods: A framework based on the principles of social marketing was developed. It consisted of 3 items: the target patient ("Who"), the target plan ("How"), and the target goal ("How many"). To test the framework, each participating pharmacy team developed their strategy by defining the 3 items and applied them during one pilot day. A master student observed the encounters between patients and pharmacy team members and used a structured checklist to document the patient's characteristics, counseling content, and strategy use. Pharmacy teams answered a feedback questionnaire at the end of the pilot day.

Results: Ten pharmacy teams were included. During a brainstorming session that lasted on average 31 ± 8 min, unique strategies comprised 18 different target patients and 20 different target plans. The planned target goal was a mean of 31 patients (range: 1 to "all"). A total of 325 encounters were observed, of which 208 patients (64%) corresponded to the predefined target patients. Medication adherence was addressed with 73 patients (22.5%), and adherence counseling was performed with 50 patients (15%). The pharmacy teams accepted the framework and judged it feasible and adaptable to their needs.

Conclusion: The proposed framework represents a simple tool that enables pharmacy teams to develop a strategy for addressing medication adherence in community pharmacies. Its adoption by pharmacy teams occurred without additional training and its integration into daily practice without difficulties. A further study is now needed to investigate if pharmacy teams can successfully engage patients in discussion on medication adherence and ultimately propose targeted adherence interventions.

Keywords: Community pharmacy services; Counseling; Medication adherence; Pharmaceutical care; Social marketing; Strategy.