Shakeri Ahmad, Dolovich Lisa, MacCallum Lori, Gamble John-Michael, Zhou Limei, Cadarette Suzanne M
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada.
School of Pharmacy, University of Waterloo, Kitchener, ON N2L 3G1, Canada.
Pharmacy (Basel). 2019 Aug 12;7(3):115. doi: 10.3390/pharmacy7030115.
MedsCheck (MC) is an annual medication review service delivered by community pharmacists and funded by the government of Ontario since 2007 for residents taking three or more medications for chronic conditions. In 2010, MC was expanded to include patients with diabetes (MCD), home-bound patients (MCH), and residents of long-term care homes (MCLTC). The Ontario government introduced an abrupt policy change effective 1 October 2016 that added several components to all MC services, especially those completed in the community. We used an interrupted time series design to examine the impact of the policy change (24 months pre- and post-intervention) on the monthly number of MedsCheck services delivered. Immediate declines in all services were identified, especially in the community (47%-64% drop MC, 71%-83% drop MCD, 55% drop MCH, and 9%-14% drop MCLTC). Gradual increases were seen over 24 months post-policy change, yet remained 21%-76% lower than predicted for MedsCheck services delivered in the community, especially for MCD. In contrast, MCLTC services were similar or exceeded predicted values by September 2018 (from 5.1% decrease to 3.5% increase). A more effective implementation of health policy changes is needed to ensure the feasibility and sustainability of professional community pharmacy services.
药物检查（MC）是一项年度药物审查服务，自2007年起由社区药剂师提供，并由安大略省政府资助，面向患有慢性病且正在服用三种或更多药物的居民。2010年，药物检查服务范围扩大到包括糖尿病患者（MCD）、行动不便患者（MCH）以及长期护理机构居民（MCLTC）。安大略省政府于2016年10月1日突然实施了一项政策变更，为所有药物检查服务增加了几个组成部分，尤其是在社区完成的服务。我们采用中断时间序列设计，来研究政策变更（干预前后各24个月）对每月提供的药物检查服务数量的影响。我们发现所有服务立即下降，尤其是在社区（MC下降47%-64%，MCD下降71%-83%，MCH下降55%，MCLTC下降9%-14%）。政策变更后的24个月内出现了逐渐增长，但仍比社区提供的药物检查服务预期值低21%-76%，尤其是对于MCD服务。相比之下，到2018年9月，MCLTC服务与预测值相近或超过了预测值（从下降5.1%变为增长3.5%）。需要更有效地实施卫生政策变更，以确保社区专业药房服务的可行性和可持续性。
