Is there a role for the community pharmacist in the management of long-term conditions?

Abstract The Government agenda is to move pharmacists away from dispensing medicines from a prescription to the provision of clinical services aimed at managing patients with long-term conditions. This thesis uses the approach defined by the MRC framework for developing complex interventions to ascertain whether there is a pharmacist role in this area. An initial study was conducted to determine the feasibility of a community pharmacist eczema management support service (PLEEZ). It demonstrated encouraging results, however failed to recruit the required number of participants. A pharmacist focus group indicated that the study had failed because of an insufficient population, overly complex study design and insufficient intervention preparation and training. Type 2 diabetes was subsequently chosen for the intervention as these patients have an anticipated greater pharmaceutical need and there is a larger available patient population. In line with the MRC framework, appropriate developmental work was then undertaken in the form of a literature review, an audit and a series of focus groups to determine the composition of a novel intervention focused on this condition. These results came together to form the diabetes community pharmacy drop-in clinic comprising the following elements:  Targeting poorly controlled patients  A system of referral from the medical practice  A suitable training programme  No appointment system  Additional pharmacist to support  A focus on adherence and dose optimisation as well as diet and lifestyle advice The clinics, in five pharmacies, recruited 33 participants providing positive results from the outcomes measured, excellent patient feedback and pharmacist comments that can be used to inform future studies. The thesis demonstrates that there is a potential role for the community pharmacist in the care of patients with type 2 diabetes, however further, large scale research is needed to confirm whether this is the case.

Name dc:type.qualificationname

phd

Level dc:type.qualificationlevel

doctoral

Grantor dc:publisher.institution

University of East Anglia

Year dc:date.issued

2013

Author dc:creator

• Twigg, Michael

Language dc:language

en