Title: Chairs: 74 th FIP World Congress of Pharmacy and Pharmaceutical Sciences Forum for innovators: Pharmaceutical services implementation – Successes and outcomes case study from Lithuania Jūratė Švarcaitė Pharmaceutical care programmes manager, Nemuno vaistinė
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Title:
Chairs:
74th FIP World Congress of Pharmacy
and Pharmaceutical Sciences
Forum for innovators: Pharmaceutical services
implementation – Successes and outcomes
case study from Lithuania
Jūratė ŠvarcaitėPharmaceutical care programmes manager, Nemuno vaistinė
Geography
Key facts and figures
- 3 million inhabitants
- 1,400 Pharmacies
-Market is dominated by 3 major pharmacy chains.
- Camelia pharmacy chain
-300 pharmacies (270 operated directly and 30 by franchise partners),
-400 pharmacists and 300 pharmacy technicians,
-1st by the number of pharmacies and 2nd by turnover.
- Pharmacy remuneration
-Regressive margin,
-Average margin 15%.
-Pharmacy services
-Dispensing service.
3
ANSWER: Pharmacy services…
• Pharmacies compete by prices and discounts,
• Rumours about tenders,
• Prices of medicines are falling,
• Demotivated workforce,
• Nurses acquiring more competencies in healthcare services delivery,
• Implementation of pharmaceutical care in national legislation from 2015,
• …
… You have to start somewhere
PILOT PROJECT: PHARMACEUTICAL CARE SERVICE TO ASTHMA PATIENTS
• Project partner Glaxo Smith Kline (education grant and In check dial devices),
• 17 pilot sites- pharmacies,• 8 in big cities,
• 9 in towns,
• 40 pharmacists• Trained in asthma care and appropriate inhalation
• Collect evidence to support wider service roll out and reimbursement.
TIMEFRAME
Training04.07-
08 Project kick-off
05.01
Mid-term
evaluation
07.31Evaluati
on09.30
IN THE PHARMACY
• Materials and equipment:• InCheck Dial medical device,
• Demo inhalers,
• Asthma Control Test,
• Pharmacy protocol and intervention form,
• Personalised Patient information leaflet,
• Posters in the pharmacies,
• Advertising on the website,
• Information leaflets for local GPs.
• Service takes approx. 10-15 min (free):• Completing ACT,
• Providing education and counseling,
• Documentation .
PHARMACY SUPPORT AND MARKETING
Practitioner support:
• Regular visits to the pharmacies,
• Regular e-mail and phone communication with practitioners,
Marketing:
• 5 presentations to selected local Primary Care Centers,
• Advertising to patients (website and journal).
• Advertising in local media.
MID TERM RESULTS (I)
• Full service received by 172 asthma patients:
- Average age of a patient 62 years old (9 children).
- 99 female, 73 male patients.
• Average asthma control score 15,8 (the worst result recorded 4).
• 68% of the cases asthma control was unsatisfactory (>19).
• Average number of mistakes when using inhaler 2,11 (the worst score 10 mistakes).
• 72% of patients did at least one mistake when inhaling.
MID TERM RESULTS (II)
• 7 patients were prescribed inhaler for the first time.
• 7 patients were using only symptom reliever (salbutamol).
• Most frequent inhalation mistakes: doesn’t exhale before inhalation (4), incorrect inhalation strength (6), doesn’t hold their breath (7), didn’t rinse their mouth after inhalation (12).