The impact of community pharmacists on older adults in Turkey.

OBJECTIVE: This study aimed to evaluate the impact of theory-based, structured, standardized pharmaceutical care services led by community pharmacists (CPs) on patient-related outcomes in older Turkish adults. PRACTICE DESCRIPTION: This prospective, quasi-experimental pilot study was conducted at the national level at community pharmacies in Turkey. After virtual training of CPs, pharmaceutical care services including medicine bag check-up, medication review, patient medicine card, patient education, and counseling services (including motivational interviewing) were delivered to promote medication adherence in older adults. PRACTICE INNOVATION: Theory-based, structured, standardized pharmaceutical care services addressing medication adherence problems in older Turkish adults with noncommunicable diseases. EVALUATION METHODS: Descriptive data (including demographic and clinical data, medication-related problems by using the DOCUMENT classification, potential inappropriate prescribing by using the Ghent Older People's Prescriptions Community Pharmacy Screening- (GheOP3S) tool, and pharmacy service satisfaction) were presented. Pre- and post-evaluation were compared by using the Wilcoxon test (for continuous variables) and McNemar's or McNemar-Bowker chi-square test (for categorical variables). RESULTS: One hundred and thirty-eight medication-related problems were identified among 52 older adults. The medication adherence rate was significantly increased from 51.9% to 75%, and the mean of total quality of life (QoL) score rose significantly from 51.7 to 53.4 (P < 0.05). There was a statistically significant change in the median of necessity-concern differential (baseline: 7 [2.2-10.0] vs. final: 8.0 [5-11]; P < 0.05). At baseline, all patients had at least 1 potential inappropriate prescribing according to the GheOP3S tool, and the rate was 73.1% at the final assessment. CONCLUSION: Community pharmacist-led pharmaceutical care services significantly improved patient-related outcomes (such as medication adherence, beliefs about medication, and QoL) in older adults with noncommunicable diseases. No statistically significant change was detected in their lifestyle behaviors (such as physical activity and diet program) or health awareness.

Turkish community pharmacists' behavioral determinants in provision of pharmaceutical care to elderly patients.

Background It is crucial to develop and implement community pharmacist-led pharmaceutical care services in primary care that could prevent and detect potentially inappropriate prescribing and promote medication adherence in older patients. Objective The aim of this study was to determine community pharmacists' perceived barriers and facilitators face during the provision of pharmaceutical care to older patients by using a theoretical domains framework. Method A cross-sectional online survey was conducted among community pharmacists in Turkey. A Turkish version of the 50-item Determinants of Implementation Behavior Questionnaire was developed to evaluate behavioral determinants of community pharmacists on delivering pharmaceutical care to older patients. Main outcome measures The behavioral determinants of community pharmacists. Results A total of 354 community pharmacists answered the questionnaire. The mean age was 43.2 (standard deviation = 11.1), and 227 (64%) of the pharmacists were female. Community pharmacists' positive opinions on pharmaceutical care service outcomes in older patients and feedback were regarded as facilitators. Community pharmacists' motivational level and emotions were additional determinant facilitators in delivering pharmaceutical care to older patients. Their negative opinions on the impact and action of pharmaceutical care in older patients were regarded as barriers. Conclusion In primary health care, a theory-based e-distant training program for community pharmacists and the guidelines for standard pharmaceutical care services led by community pharmacists could be designed by addressing barriers related to the impact and action of pharmaceutical care in older patients.