Kevin P Mc Namara1, Ines Krass2, Gregory M Peterson3, Hamzah Alzubaidi4, Rob Grenfell5, Ben Freedman6, James A Dunbar7. 1. School of Medicine, Deakin University, Geelong, Victoria, Australia; Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia; Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia. Electronic address: kevin.mcnamara@deakin.edu.au. 2. School of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia. 3. School of Medicine, Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia. 4. University of Sharjah, Sharjah Institute for Medical Research and College of Pharmacy, Sharjah, United Arab Emirates. 5. CSIRO Health and Biosecurity, Parkville, Victoria, Australia. 6. Heart Research Institute/Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia; Sydney Medical School, University of Sydney, Camperdown, New South Wales, Australia. 7. Centre for Population Health Research, Deakin University, Geelong, Victoria, Australia.
Abstract
BACKGROUND: Screening is a critical component of efforts to reduce the population burden of cardiovascular disease (CVD), by facilitating early use of cost-effective prevention and treatment strategies. While international evidence suggests that screening in community pharmacies improves screening access and identifies at-risk individuals, concerns from medical organisations about the absence of interdisciplinary coordination and related lack of continuity of care with general practice have significantly contributed to reluctance from some stakeholders to endorse, and engage with, pharmacy-based screening initiatives. The Cardiovascular Absolute Risk Screening (CARS) study was designed to address these challenges and promote an interprofessional approach to screening for cardiovascular disease risk by pharmacists. This study describes the impact of the CARS implementation model on interdisciplinary coordination and continuity of care. METHODS: In addition to clinical training, pharmacists at eleven participating pharmacies were provided with implementation training, resources and support to promote interprofessional coordination. Completion of training and pharmacy implementation plans, both of which highlighted GP engagement strategies, were pre-requisites for screening commencement. Using mixed methods approaches, data were analyzed from screening records (n = 388), researcher interviews with patients at 6-10 weeks post-screening (n = 248, 64%), and pharmacist interviews (n = 10). RESULTS: Screening records suggested that 94% of screened individuals were advised to seek formal GP assessment, and 98% consented to sharing of results. Among interviewed participants, 81% recalled direct pharmacist action to facilitate GP engagement. Among interviewees who had seen their GP already (n = 70), 79% reported that their GP was aware of the results (another 16% were uncertain). Pharmacists reported positive GP feedback stemming from efforts at early engagement, but an absence of ongoing collaboration. CONCLUSIONS: Use of implementation planning by pharmacists, alongside clinical training, can effectively promote an interdisciplinary coordination focus by pharmacists.
BACKGROUND: Screening is a critical component of efforts to reduce the population burden of cardiovascular disease (CVD), by facilitating early use of cost-effective prevention and treatment strategies. While international evidence suggests that screening in community pharmacies improves screening access and identifies at-risk individuals, concerns from medical organisations about the absence of interdisciplinary coordination and related lack of continuity of care with general practice have significantly contributed to reluctance from some stakeholders to endorse, and engage with, pharmacy-based screening initiatives. The Cardiovascular Absolute Risk Screening (CARS) study was designed to address these challenges and promote an interprofessional approach to screening for cardiovascular disease risk by pharmacists. This study describes the impact of the CARS implementation model on interdisciplinary coordination and continuity of care. METHODS: In addition to clinical training, pharmacists at eleven participating pharmacies were provided with implementation training, resources and support to promote interprofessional coordination. Completion of training and pharmacy implementation plans, both of which highlighted GP engagement strategies, were pre-requisites for screening commencement. Using mixed methods approaches, data were analyzed from screening records (n = 388), researcher interviews with patients at 6-10 weeks post-screening (n = 248, 64%), and pharmacist interviews (n = 10). RESULTS: Screening records suggested that 94% of screened individuals were advised to seek formal GP assessment, and 98% consented to sharing of results. Among interviewed participants, 81% recalled direct pharmacist action to facilitate GP engagement. Among interviewees who had seen their GP already (n = 70), 79% reported that their GP was aware of the results (another 16% were uncertain). Pharmacists reported positive GP feedback stemming from efforts at early engagement, but an absence of ongoing collaboration. CONCLUSIONS: Use of implementation planning by pharmacists, alongside clinical training, can effectively promote an interdisciplinary coordination focus by pharmacists.
Authors: Sarah Rondeaux; Tessa Braeckman; Mieke Beckwé; Natacha Biset; Joris Maesschalck; Nathalie Duquet; Isabelle De Wulf; Dirk Devroey; Carine De Vriese Journal: Int J Environ Res Public Health Date: 2022-07-17 Impact factor: 4.614