TORONTO, ON (July 2016) — Ontario’s MedsCheck medication review programs provide a valuable health service but after nine years it’s clear that pharmacists need to improve their documentation and sharing of service records to make the information easily accessible to patients and their physicians.
As well, program refinements are needed to ensure that pharmacists are providing the service to those with the highest needs and going beyond obtaining a reconciled medication list to assessing a person’s medication-taking behaviour and intervening as needed to achieve better health outcomes.
These were some of the conclusions reached by a study of the MedsCheck program conducted by members of OPEN — the Ontario Pharmacy Research Collaboration.
The research was conducted by a team led by Linda MacKeigan, of the Leslie Dan Faculty of Pharmacy at the University of Toronto, and Lisa Dolovich, of the Department of Family Medicine at McMaster University. Parts of the research were conducted with the Toronto Health Economics and Technology Assessment Collaborative.
Dolovich, also the co-lead of OPEN — a consortium of academic scientists from seven institutions who research the impact of approaches to improve medication management — presented an overview of OPEN’s multiple research projects at the 50th Annual Ontario Pharmacists Association’s Conference in Toronto in June. Over a three-year period these projects collectively evaluated the impact of government pharmacy policies and pharmacist medication management services in Ontario.
“For MedsCheck, we found that, over time, the reviews were being provided to less complicated patients and that community pharmacies’ focus was more on the uptake — providing more services — than on the quality of the reviews,” said Dolovich.
“For example, while most medication lists prepared for patients contained basic prescription information, less than half recorded the reason for the use of the medication and only about 75 percent noted any assessment of medication-taking behaviour.”
The MedsCheck evaluation used data from government administration and billing records; interviews with community pharmacy decision makers and external stakeholders; surveys of physicians, patient and pharmacists; and pharmacy audits. Its main findings are in the process of being published.
Dolovich said the findings can help Ontario’s Ministry of Health and Long-Term Care, as well as community pharmacies, tailor the important program to improve its value for patients and the healthcare system as a whole by shifting the focus of service development efforts to improving the quality of program delivery.
“Our findings show why real-life evaluation of government policy is so important,” said Dolovich.
She noted that people are taking more and more medications especially as they age and that pharmacists are medication experts who can help ensure people are getting the most benefit and the least harm from their medications, and help advise when to start, change or stop medications.
“We need to ask: ‘Is the MedsCheck service being provided as intended and is the program having the intended benefits?’ That way adjustments can be made so that resources are used wisely and with greater impact,” Dolovich said.
“The MedsCheck research team also evaluated the Ontario government’s Pharmaceutical Opinion Program, finding that the most frequent outcome of Pharmaceutical Opinions was the physician changing the prescription. This result helps to establish the role of the pharmacist on the healthcare team, especially to prevent adverse medication events,” said MacKeigan.
“However, our audit of pharmacies from four regions across Ontario revealed gaps in documentation in as many as 50 percent of Pharmaceutical Opinions, suggesting that skills development workshops are needed.”
Find out more about OPEN and the MedsCheck and Pharmaceutical Opinion Programs Project.
Program Manager, OPEN: Ontario Pharmacy Research Collaboration
School of Pharmacy • Health Sciences Campus • University of Waterloo
10A Victoria Street South • Kitchener, ON N2G 1C5
For more information about recent enhancements to the MedsCheck Program, based in part on OPEN’s research, please see the Ministry of Health and Long-Term Care’s July 4, 2016 Notice from the Executive Officer (English PDF; French PDF) and the Ontario Pharmacists Association’s bulletin with information for pharmacists.
This research was funded by the Government of Ontario through the Health System Research Fund. The views expressed are those of the researchers and do not necessarily reflect those of the funder.