Pharmaceutical care experiences and expectations in elderly patients in a private residency
Janse van Rensburg, A
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Pharmaceutical care in South Africa is not a formalised process. This study highlights the expectation amongst the elderly to receive pharmaceutical care. The expectations and experiences of an elderly population in terms of pharmaceutical services was also examined. Pharmacists and healthcare funders in South Africa should consider the value of pharmaceutical care added to the pharmaceutical services that forms part of their day-to-day activities. The pharmacist, a drug specialist, should be an integral part of the clinical healthcare team. The study was done with two main objectives: A comprehensive literature review included the reason and development of pharmaceutical care, roles of the pharmacist, the challenges in supplying pharmaceutical care locally and internationally, with specific focus on the value and impact of pharmaceutical care to the elderly. The empirical study consisted of a cross-sectional study that used a structured questionnaire administered by the researcher in face-to-face interviews, to obtain data. The study population was 67 elderly participants in a specific retirement village in a suburban area in Johannesburg, South Africa. Participants had to be ≥65 years of age. Data was captured using Excel® and analysed using IBM SPSS Statistics for Windows version 22.0. All statistical significance was considered with a two-sided probability of p<0.05. The practical significance of results was computed when the p-value was statistically significant (p≤0.05). Variables (age groups, gender, etc.) were expressed using descriptive statistics such as frequency (n), percentage (%), mean and standard deviation. The dependent t-test was used to compare the difference between experience and expectation. Cohen’s d-value was used to determine the practical significance of the results (with d ≥ 0.8 defined as a large effect with practical significance). The results of the study relating to pharmaceutical care showed that there were both practically and statistically significant differences between the expectations of the population in terms of all three phases of pharmaceutical care and their actual experiences. There were no significant differences between the responses of the participants regardless of age, sex, amount of chronic diseases, primary medicine provider or medicine funders. The largest difference between experience and expectation, based on Cohen’s d-value (p<=0.001, d=1.46) was that. 95.5 % of the elderly patients perceived that the pharmacist “never” asses their medication required (3.93±0.36), but 32.8 % of the respondents indicated that it should “always” happen (2.28±1.13). The results of the study relating to pharmaceutical services showed that this population of elderly patients expected more of the pharmacist in terms of pharmaceutical services, than they actually received. Discussions about the effect of other medicines on their chronic medicine (d=1.94); whether they have any medicines left from previous issues (d=1.77); and questions regarding existing chronic conditions (d=1.69) showed statistically and practically significant differences. There was an association between questions regarding the use of chronic medicines at pharmacies and at other healthcare professionals (d=0.26), as well as the supply of written information at pharmacies and other healthcare professionals (d=0.42). This study highlights shortcomings in the role of the pharmacist as a healthcare team member. Pharmacists in South Africa do not supply pharmaceutical care. When questioned about the components of pharmaceutical care the elderly population indicated that they expected that care. The community pharmacist should focus on the health-related quality of life of the individual patient and identify the immediate healthcare needs of their unique community (Catic, 2013:206), with specific reference to vulnerable populations like the elderly. Pharmacists have the knowledge and opportunity to address these needs. They need to establish themselves as the go-to healthcare professional.
- Health Sciences