Authors (including presenting author) :
LEE B (1)(2), NGAN T(1), CHAN G(1), YUNG T(1), CHUNG F(1), WONG J(2), LAI W(2), CHU P(3), YOUNG G (3), LIU A(4), FAN C(4)
Affiliation :
(1) Chief Pharmacist’s Office, HAHO; (2) Pharmacy Department, PWH; (3) Pharmacy Department, TMH; (4) Pharmacy Department, PYNEH
Introduction :
In line with HA’s corporate strategies of increasing capacity of high-demand services and reinforcing clinical risk management, the Drug Refill Services (DRS) has started implementation in selected specialist outpatient clinics (SOPC) since 2017-18. An interim review of DRS was conducted in April 2020.
Objectives :
DRS aims to enhance pharmaceutical care and medication safety, reinforce patients’ drug knowledge for better compliance and safety; and reduce the risks of excess drug storage. The interim review evaluates DRS on these aims and suggest future directions
Methodology :
The interim review evaluates DRS in: (1) Patient profiling – precision of selection criteria in identifying patients in need of DRS; (2) Drug wastage – impact of DRS on reducing drug wastage; (3) Stakeholder feedback – evaluating feedback from stakeholders for future service improvement; and (4) Logistics – review of workflow to identify areas for streamlining.
Result & Outcome :
DRS has met its original objectives and additionally brought about wide-ranging positive impact on hospital practice and patient service. The review found that, with 20,000 patients successfully recruited, ~18,500 DRS refill cases were flagged for review, with resulting interventions including counselling with patients on drug-related problems, adjustment of refill quantities, and change or discontinuation of drug regimens after consultation with clinicians. Patients and old-age home staff responded favourably to the programme, according to a user experience survey conducted in the 2 initial DRS hospitals. Drug wastage reduction as a result of aborted refills and reduced dispensing quantities totalled $2.5 million out of those patients recruited.
Additional benefits brought about by DRS include: Hospitals rode on the protocol-driven model of DRS to develop additional shared care models, enabling regular patient follow-up on compliance and therapy effectiveness; the use of tele-service technology enabled future development of new modes of remote service provision and collaboration; Medication reconciliation (MR) message exchange between HA’s clinical systems, enabled timely clinical communication across HA; Use of smart technology for track-and-trace, patient self-service and performance management, provided proof-of-concept for future service development; Big data analytics was found well-suited for clinical data accumulated in DRS to improve precision and timeliness of high-risk patient selection in future clinical programmes.
