Background and Objectives: Community pharmacy screening for chronic disease risk factors can promote early detection. Little is known about how pharmacy services are used post-screening. The PIAAF Pharmacy study screened elderly participants for hypertension, diabetes, and atrial fibrillation (AF) in 26 pharmacies in Ontario and Alberta. The primary objective was to determine whether patients screening at risk for AF, hypertension and diabetes had increased odds and rates of pharmacy service receipt than those at lower risk.
Methods: Participants’ pharmacy data were extracted. A conceptual framework of potentially influential factors was constructed. Measurable factors were used as variables in regression analyses. Generalized estimating equations (GEE) were created to model 1) receipt of all pharmacy services, 2) receipt of medication review, and 3) receipt of influenza vaccination.
Results: 165 of 535 patients received 229 pharmacy services. 64% were medication reviews and 25% were influenza vaccinations. Screening at high risk for diabetes, hypertension, and AF was not associated with increased receipt of pharmacy services, except for influenza vaccine, which was associated with screening as high risk for diabetes (OR = 1.69 [95% CI 1.09, 2.64]). Screening in October (IRR = 2.85 [95% CI 1.67, 4.84]), eligibility for annual-only medication reviews (IRR = 2.15 [95% CI 1.53, 3.01]), number of medications (IRR = 1.92 [95% CI 1.07, 3.46]), new medications (IRR = 2.00 [95% CI 1.37, 2.93]), and living in Alberta (IRR = 1.46 [95% CI 1.07, 2.01]) were associated with increased rates of receiving pharmacy services.
Discussion and Conclusions: Screening results were not associated with increased receipt of pharmacy services, with the exception of influenza vaccine and high risk of diabetes. A gap exists between screening and pharmacy service receipt. Pharmacists can use screening interventions and individual screening results as an opportunity to provide pharmacy services to those with chronic disease risk factors. / Thesis / Master of Health Sciences (MSc) / Community pharmacies may be ideal locations for screening of chronic diseases such as diabetes, high blood pressure, and abnormal heart rhythms. It is not well understood how pharmacy services are used in people after screening for these risk factors. This project aims to see if people screening at higher risk levels were more likely to receive pharmacy services than those at lower risk. We used patients’ pharmacy data to see what services they had received after screening, and then created statistical models to determine which patient-, pharmacy-, community-, and screening-related factors were associated with a greater chance of receiving pharmacy services. Being at risk of diabetes, high blood pressure, and irregular heart rhythms were not associated with a greater likelihood of receiving pharmacy services, except in those at high risk for diabetes—these patients were found be associated with a higher chance of receiving flu shots.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/21460 |
| Date | 05 1900 |
| Creators | Lancaster, Karla |
| Contributors | Dolovich, Lisa, Health Research Methodology |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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