The role of community pharmacists in disease prevention: A study of the delivery of clinical pharmacy services in community pharmacy in Ireland

Abstract

The Role of Community Pharmacists in Disease Prevention: A Study of the Delivery of Clinical Pharmacy Services in Community Pharmacy in Ireland

Susan O Dwyer

Aims The overall aim of this research was to explore the role of the community pharmacist in disease prevention by evaluating the delivery of a number of clinical pharmacy services in the community pharmacy setting in Ireland.

Methods A combination of qualitative and quantitative methodologies was used to explore the role of community pharmacists in disease prevention through the delivery of clinical pharmacy services. A literature review was carried out to identify work which had already been published in this area. An observational design was employed to review the delivery of a smoking cessation intervention and an ambulatory blood pressure monitoring service. The role of community pharmacists in supporting adherence to inhaler medication in patients with asthma and/or chronic obstructive pulmonary disease was assessed via a cluster randomised study design.

Results The smoking cessation initiative was successful in supporting patients with a quit attempt and a 12-week carbon monoxide verified abstinence rate of 5.52% was observed. The ambulatory blood pressure monitoring service facilitated the detection of both hypertension and pulse patterns potentially indicative of atrial fibrillation with prevalence estimates observed broadly in line with previous estimates in primary care in Ireland. Significant differences in clinical and humanistic outcomes between intervention and usual care participants were observed in the inhaler adherence intervention as was a trend towards improved inhaler adherence, technique mastery and symptom control amongst intervention participants.

Conclusions This research shows that delivery of clinical pharmacy services in the community pharmacy setting in Ireland is feasible. The interventions described facilitated health behaviour change to support primary disease prevention, detection of both hypertension and pulse patterns indicative of atrial fibrillation as a secondary prevention measure and improvements in medication usage in patients with respiratory disease to support tertiary disease prevention. The services described represent an expansion of the role of the community pharmacist within the Irish healthcare system.