Home Care Pharmacy Practice in Canada: A Cross-Sectional Survey of Services Provided, Remuneration, Barriers, and Facilitators
Author(s):
Linda MacKeigan
Affiliations:
BScPharm PhD
Canadian Pharmacists Conference ePoster Library. Houle S. Jun 4, 2017; 174251
Dr. Sherilyn Houle
Dr. Sherilyn Houle
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Abstract
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Objectives
Despite the medical complexity of patients receiving home care, pharmacists appear to be rarely formally acknowledged as members of home care teams. The aim of this study was to determine the number of Canadian pharmacy practices providing services to patients in their homes.

Methods
A web survey was designed and disseminated to Canadian pharmacists via pharmacy association newsletters and through targeted emails to those known to practice in the area. Respondents who are currently practicing, conduct at least one home visit per week for clinical purposes, and who document these visits were eligible. The survey examined the frequency of visits, medication management needs of patients, care provided, documentation practices, and perceived barriers and facilitators. One survey was to be completed per work site to capture the number of unique practices in Canada.

Results
17 practices were identified from October-December 2015, comprising 7 community pharmacies, 3 consultant practices, 3 home care agencies or government-administered programs, 2 outpatient clinics, and 2 hospitals. Three practices charged a home care agency, and 5 received remuneration from provincial pharmacy services billing programs, while 3 received no remuneration. The remainder consisted of funded staff positions within a home care program. A median of 9 visits were performed per practice per month, with the highest number observed among pharmacists employed by independent community pharmacies and home care agencies. Medication reviews and adherence assessments were the most common reason for referrals. 12 of 17 respondents collected some form of outcome data. Referrals from other health professionals and supportive management were the key facilitators of the service, while insufficient reimbursement and resistance from other health professionals were key barriers.

Conclusion
Pharmacist home services appear to be an infrequent area of practice nationally. Future work will examine the impact of pharmacist practice in home care on patient and health system outcomes.

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