Medication Review Services in Primary Care: Success in Slovenia
Mitja Kos, Head of Social Pharmacy at the University of Ljubljana, shares the success and experience of medication review services in primary care in Slovenia. The Pharmaceutical Care Network Europe (PCNE) aims at stimulating research projects, organizing conferences, and improving health outcomes through pharmaceutical care. Explore the positive attitude, knowledge, and skills necessary for advancing medication review practices. Learn about the structured evaluation of patient medicines to optimize their use and enhance health outcomes.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
Medication review services in primary care- experience from Slovenia Mitja Kos Head, Chair of Social Pharmacy University of Ljubljana, Faculty of Pharmacy E-mail: mitja.kos@ffa.uni-lj.si Chairman, Pharmaceutical Care Network Europe (PCNE)
Pharmaceutical Care Network Europe Pharmaceutical care researchers in Europe Established in 1994 Aim: stimulating research and implementation projects organising working conference and a symposium 2nd-3rd February 2018 Seamless care www.pcne.org
Pharmaceutical Care Pharmaceutical Care is the pharmacist s contribution to the care of individuals in order to optimize medicines use and improve health outcomes. PCNE 2013 And several other defintions in the past. http://www.pcne.org//upload/files/3_PCNE_Definition_Position_Paper_final.pdf
Past activities PhC programs: hypertenson, asthma, ask about your medicines, diabetes Undergraduate and postgraduate education A number of conferences & symposia Theses, specialisations & other research Submissions to the health council in order to get remuneration
Positive attitude Knowledge & skills Long, unfocused programs not acceptable Weak arguments not always count Developments at the international level
Medication review new/old?
Medication review Medication review is a structured evaluation of patient s medicines with the aim of optimizing medicines use and improving health outcomes. This entails detecting drug related problems and recommending interventions. PCNE consensus 2016 MR services: those that are based on such activity.
Retrospective review => Ph. Care Retrospective review of information MR
Retrospective review => Ph. Care Intervention Retrospetive review of information MR
Retrospective review => Ph. Care Intervention Outcomes? ECHO Retrospetive review of information MR
Retrospective review => Ph. Care Monitoring & Follow-up Intervention Intervention Intervention Outcomes ECHO Retrospetive review of information MR MR MR
Two sided process Concept Standards Procedures In cooperation with:
Pilot project in 2012, economic crisis Main driver: rationalisation, at the back the complexity of polypharmacy
Questions Access to health care documentation Confidentiality Is a pharmacist a health care provider?
Questions Access to health care documentation Confidentiality Is a pharmacist a health care provider? YES
Questions Access to health care documentation Confidentiality Pharmacist is a health care provider. Is this obvious to everybody? NOT YET
Developments in Slovenia Medication use review Pregled uporabe zdravil Type 2a Avanced medication review Farmakoterapijski pregled Type 3
Developments in Slovenia Medication use review Pregled uporabe zdravil Type 2a Focus on patient M.Pharm. Avanced medication review Farmakoterapijski pregled Type 3 Recommendations to physicians M.Pharm. & specialist in clinical or community pharmacy
ZZZS pilot project Avanced medication review Farmakoterapijski pregled Type 3 Health care centers, primary level financing Referral by the physician Recommendations to physicians Pharmacotherapeutic groups at the local level M.Pharm. & specialist in clinical or community pharmacy
Health Care Team Collaboration It will not work for the patient if the collaboration is not in place. http://dominosdesigns.files.wordpress.com/2012/08/softball-circle-hands.jpg
Health care system financing Ambulatory setting fee for service Hospital setting Diagnosis Related Groups
Remuneration 2016 Medication use review Pregled uporabe zdravil Type 2a Focus on patient M.Pharm. Free or out of pocket Avanced medication review Farmakoterapijski pregled Type 3 Health care centers, primary level financing Referral by the physician Recommendations to physicians Pharmacotherapeutic groups at the local level M.Pharm. & specialist in clinical or community pharmacy Remunerated by Health Insurance Institute of Slovenia, since 2016
Assuring quality Slovene Chamber of Pharmacy Certification of competencies Courses: theory + practice with menthors A special body Skrbnik kompetenc Assuring quality: development & monitoring of MR services Continuing Professional Development http://www.lek-zbor.si/
Research support Faculty of pharmacy Randomised controlled trial of medication use review Observational study of advanced level medication review Exploratory studies of adherence, other DRPs, health care outcomes, innapropriate prescribing: Pharmacoepidemiology (health claims data) Observational study (prospective/retrospective studies) Cooperation at the international level: PRACTISE study: PhaRmAcist-led CogniTIve Services in Europe
Upgrade of specialisation One, upgraded specialisation in clinical pharmacy Before: two specialisations in community pharmacy and clinical pharmacy Much more clear what are the competencies First time a special service dedicated to the specialist Introduction of activities currenly run to assure certification into the specialisation program
Change of the law Pharmacy Practice Act 2016 Before: Provison of medicines After: also special focus on services: PhC, seamless care Can a pharmacist be involoved in MR service without being at least partly employed in a pharmacy (community or hospital)? Who is the boss? What is the support to the pharmacist, continuing professional development, etc.? What is the relation with other colleagues? Where is the base?
Future Innovative, Integrated and Individualised Care
