Authors (including presenting author) :
Lee MM(1), Kwok WY(1), Lau YM(1), Pang WS(1), Chan FC(1), Ho KL(1), A Kong(4), L Ngai(4), C Leung (4), I Tam(5), Mok CK(2), Au Yeung TW(1), P Chu(3), Lam YM(1)
Affiliation :
(1) Community Care Division, New Territories West Cluster (2) Department of Medicine ad Geriatrics, Tuen Mun Hospital (3) Department of Pharmacy, New Territories West Cluster (4) Yan Oi Tong Outreach Pharmacy Team (Medical Service Division) (5) Yan Oi Tong Integrated Home Care Services Team (Social Service Division)
Introduction :
Medication non-adherence is one of the main causes for hospital readmission for elderly patients and is a significant burden for public healthcare service in Hong Kong. A pilot collaboration of NTWC Community Nursing Service (CNS) and Yan Oi Tong Outreach Pharmacy Team (YOT OPT) was started in November 2019. Multiple strategies and interventions were adopted in this sponsored two-year project, to empower the elderly patients and their caregivers to overcome the barriers of Medication adherence, through medical- social collaboration.
Objectives :
i.Improve patients’ drug adherence and reduce medication-induced hospital readmission; ii.Improve the patients’ medication related knowledge; iii.Minimize unnecessary medication to prevent drug-drug interaction and reduce drug wastage; iv.Achieve better health outcomes for patients with chronic illness; v.Develop and implement a new “medical-social Collaboration Model” in drug management through the Public-Private-Partnership interface approach.
Methodology :
i.NTWC CNS referred eligible patients to YOT OPT ii.YOT OPT, led by registered pharmacist, provided the following services a. Provide review of medication regimen and drug reconciliation b. Organize a multi-dose medication packs or pill boxes for the eligible patients c. Provide a designated drug enquiry hotline to answer patients’ queries d. Identify suitable patients for compliance reminder phone call e. Refer eligible patients to Yan Oi Tong Integrated Home Care Services Team (YOT IHCS) support for reminding of drug taking and escorting for clinical follow up iii.Link person from both NTWC CNS and YOT OPT to keep close communication and hold regular case conference for patients’ progress and monitoring iv.NTWC CNS facilitated the communication between medical teams and YOT OPT v.Invite the Department of Pharmacology and Pharmacy of the Hong Kong University to provide an independent evaluation of this pilot Project.
Result & Outcome :
From 28th October 2019 to 12th March 2021, i.39 cases were being referred to YOT OPT (Aged from 36 to 97). ii.174 clinical pharmacist consultation at home provided, patient’s medication reviewed and reconciliation provided. iii.884 times pill box packaging organized and delivered by YOT OPT iv.107 Drug-related problems were identified and 291 interventions were given. v.35 Letters with proposed interventions were written to Doctor and 30 proposed interventions were accepted. This innovative program of Community Out-reach Pharmacy using Medical-Social Collaboration Model to enhance drug management of community living elders is feasible. One is waiting for the long results of its cost-effectiveness and generalizability.
