Community pharmacy based provision of pharmaceutical care to older patients

Aim: To measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients by community pharmacists. Method: A randomised, controlled, longitudinal, clinical trial with repeated measures was performed over an 18-month period, involving community pharmacies (5 intervention and 5 control) in Northern Ireland. Elderly, ambulatory patients (greater than or equal to 65 years), taking 4 or more prescribed medications were eligible for participation. Patients attending an intervention pharmacy received education on medical conditions, implementation of compliance strategies, rationalising of drug regimens and appropriate monitoring; patients attending control sites received normal services. A battery of clinical, humanistic and economic outcomes were assessed. Results: A significantly higher proportion of intervention patients were compliant at the end of the 18-month study and experienced fewer problems with medication compared to control patients (P < 0.05). There was little impact on quality of life and health care utilisation. Conclusions: Pharmaceutical care provision to community-dwelling patients resulted in an improvement in medication compliance and evidence of cost-savings. Future pharmaceutical care studies may benefit from a more focussed selective approach to data collection and outcomes measurement.