Integrating pharmacists into Aboriginal Community Controlled Health Services (IPAC project): protocol for an interventional, non-randomised study to improve chronic disease outcomes

Couzos, Sophia, Smith, Deborah, Stephens, Mike, Preston, Robyn, Hendrie, Delia, Loller, Hannah, Tremlett, Megan, Nugent, Alice, Vaughan, Fran, Crowther, Shelley, Boyle, Douglas, Buettner, Petra, and Biros, Erik (2020) Integrating pharmacists into Aboriginal Community Controlled Health Services (IPAC project): protocol for an interventional, non-randomised study to improve chronic disease outcomes. Research in Social and Administrative Pharmacy, 16 (10). pp. 1431-1441.

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Abstract

Background: Aboriginal and Torres Strait Islander peoples experience a higher burden of chronic disease yet have poorer access to needed medicines than other Australians. Adverse health outcomes from these illnesses can be minimised with improved prescribing quality. This project aims to improve quality of care outcomes for Aboriginal and Torres Strait Islander adult patients with chronic disease by integrating a pharmacist within primary health care teams in Aboriginal Community Controlled Health Services (ACCHSs).

Methodology: This non-randomised, prospective, pre and post quasi-experimental study, will be pragmatic, community-based and participatory, comparing outcomes and costs using paired patient data. Pharmacists will be integrated at 22 sites for approximately 15 months to conduct patient-related and practice-related activities through 10 core roles: providing medication management reviews, assessing adherence and medication appropriateness, providing medicines information and education and training, collaborating with healthcare teams, delivering preventive care, liaising with stakeholders, providing trnsitional care, and undertaking a drug utilisation review. With patients’ consent, de-identified client-level data will be extracted from clinical information systems and pharmacists will record deidentified activity in an electronic logbook. Primary expected outcomes include improvements in biometric indices (glycated haemoglobin, systolic and diastolic blood pressure, lipids, cardiovascular risk, albumin-creatinine ratio) from baseline to end of study. Expected secondary outcomes include improvements in estimated glomerular filtration rate, prescribing indices (appropriateness, overuse and underuse), medication adherence, self-assessed health, and health service utilisation indices. A qualitative assessment of stakeholder and patient perceptions and a cost-effectiveness analysis will be undertaken.

Discussion: Numerous inquiries have recommended evaluating the impact of pharmacists integrated within primary health care settings. This study is the first to explore this impact on the health of Aboriginal and Torres Strait Islander peoples who are medically underserved. Evaluation of innovative integrated workforce models is necessary to address the challenges of delivering quality care together with this population.

Item ID: 64346
Item Type: Article (Scholarly Work)
ISSN: 1934-8150
Keywords: Aboriginal; Indigenous; Pharmacist; Medication; Chronic disease; Primary health care
Copyright Information: Copyright © 2020 Elsevier Inc. All rights reserved.
Funders: Australian Government Department of Health (AGDH)
Projects and Grants: AGDH Pharmacy Trials Program (Tranche 2)
Date Deposited: 22 Sep 2020 04:03
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111717 Primary Health Care @ 50%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 100%
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