Authors (including presenting author) :
Kwok TK, Ng V, Chow CP, Ng CHE, Lau KY, Ng CHA, Chao PI, Yung T, Cheng YM, Chu TF
Affiliation :
Department of Pharmacy, Princess Margaret Hospital
Introduction :
An Ambulatory Care Pharmacy service was initiated in Medical Clinic at Princess Margaret Hospital in August 2023. This service aims to improve patient experience in medication management through an interdisciplinary care approach, providing drug education and assessment to enhance patient adherence, empowerment and satisfaction.
Objectives :
This study aims to provide an overview of Ambulatory Care Pharmacy service outcomes from 1 August 2023 to 30 November 2024.
Methodology :
Patients were recruited on referral basis for the following indication(s): 1) adherence issue; 2) drug knowledge reinforcement; 3) therapy changes for monitoring and education; or 4) additional drug monitoring for extended follow up interval.
Result & Outcome :
During the evaluation period, 2,830 cases were referred to the Ambulatory Care Pharmacy Clinic. Mean age was 69.4 years old, with an average of 9.4 medications/patient. 1,237 patients (43.7%) had medication changes indicating for drug monitoring and education (average 1.52 medication changes/patient). Changes in therapy for hypertension, diabetes, dyslipidemia, and antithrombotic agents accounted for 63% of these modifications.
Adherence issues were identified in 663 cases (23.4%), resulting in a total of 1,105 non-adherent items, representing an average of 1.67 non-adherent medications/case. The most frequently reported non-adherent medications involved gastro-antisecretory agents (16.4%), oral anti-diabetics (15.7%), and anti-hypertensives (14.9%).
In addition, 114 cases (4.0%) experienced intolerance to current therapies due to adverse drug reactions, allergic reactions, or supra-therapeutic effects, while 120 cases (4.2%) were presented with misconceptions concerning their drug therapies.
Medication review identified 134 patients were receiving concurrent drug therapies from private practitioners, 209 patients were using over-the-counter drugs/supplements, and 90 patients were taking traditional Chinese medicine. Amongst these, 41 cases (9.5%) were found to have drug interaction(s)/therapeutic duplication(s).
These issues were addressed and managed by pharmacists through patient education and, when necessary, communication with physicians. Following Ambulatory Care Pharmacy consultations, 16 cases accepted new therapeutic options that they previously had uncertainties due to misunderstanding about the options and treatment goals.
A patient experience survey (n=69) revealed that 100% expressed satisfaction with the Ambulatory Care Pharmacy service, including, reinforcement of drug knowledge, and overall service delivery.
In conclusion, our service demonstrated the value of integrating pharmacists in Ambulatory Care. This collaborative approach not only enhanced medication safety, but also empowered patients in their medication management with increased satisfaction.
