Skip to main content
Log in

Qualitative study of medication review in Flanders, Belgium among community pharmacists and general practitioners

  • Research Article
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Objective Examining the implementation barriers and facilitators of this service as provided by Belgian community pharmacists in collaboration with general practitioners. Setting Community pharmacies in Flanders. Method Qualitative study through interviews of pharmacists and general practitioners. Main outcome measure Opinions and experiences of pharmacists and general practitioners about type 3 medication review. Results Sixteen community pharmacists and thirteen general practitioners were interviewed and generally gave a positive assessment of the project. The general practitioners saw the pharmaceutical and pharmacotherapeutic recommendations of the pharmacists as an added value for the patients. The pharmacists indicated that performing an medication review was time-consuming, but that it improved their professional relationship with general practitioners and patients. They reported obstacles in obtaining information: cumbersome access to individual patient data (laboratory values) and difficulties in finding and choosing adequate medical information sources. Moreover, pharmacists indicated that there is a need for adequate reimbursement and additional training to make the implementation sustainable. Conclusion Both pharmacists and general practitioners were enthusiastic about medication reviews. The implementation improved the interprofessional collaboration. However, important barriers remain, such as the considerable investment of time and the difficulty in gathering all the necessary information. The sustainable implementation of type 3 medication review in Belgium requires adequate reimbursement and additional training.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Soares IB, Imfeld-Isenegger TL, Makovec UN, Horvat N, Kos M, Arnet I, et al. A survey to assess the availability, implementation rate and remuneration of pharmacist-led cognitive services throughout Europe. Res Social Adm Pharm. 2020;16(1):41–7.

    Article  PubMed  Google Scholar 

  2. Imfeld-Isenegger TL, Soares IB, Makovec UN, Horvat N, Kos M, van Mil F, et al. Community pharmacist-led medication review procedures across Europe: Characterization, implementation and remuneration. Res Social Adm Pharm. 2020;16(8):1057–66.

    Article  PubMed  Google Scholar 

  3. Kallio SE, Kiiski A, Airaksinen MSA, Mäntylä AT, Kumpusalo-Vauhkonen AEJ, Järvensivu TP, et al. Community Pharmacists’ Contribution to Medication Reviews for Older Adults: A Systematic Review. J Am Geriatr Soc. 2018;66(8):1613–20.

    Article  PubMed  Google Scholar 

  4. Baruth JM, Gentry MT, Rummans TA, Miller DM, Burton MC. Polypharmacy in older adults: the role of the multidisciplinary team. Hosp Pract (1995). 2020;48(sup 1):56–62.

    Article  Google Scholar 

  5. Jokanovic N, Tan EC, Sudhakaran S, Kirkpatrick CM, Dooley MJ, Ryan-Atwood TE, et al. Pharmacist-led medication review in community settings: An overview of systematic reviews. Res Social Adm Pharm. 2017;13(4):661–85.

    Article  PubMed  Google Scholar 

  6. Griese-Mammen N, Hersberger KE, Messerli M, Leikola S, Horvat N, van Mil JWF, et al. PCNE definition of medication review: reaching agreement. Int J Clin Pharm. 2018;40(5):1199–208.

    Article  PubMed  Google Scholar 

  7. Hatah E, Tordoff J, Duffull SB, Braund R. Pharmacists’ performance of clinical interventions during adherence support medication reviews. Res Social Adm PharmP. 2014;10(1):18–94.

    Article  PubMed  Google Scholar 

  8. Hatah E, Braund R, Tordoff J, Duffull SB. A systematic review and meta-analysis of pharmacist-led fee-for-services medication review. Br J Clin Pharmacol. 2014;77(1):102–15.

    Article  PubMed  Google Scholar 

  9. Blenkinsopp A, Bond C, Raynor DK. Medication reviews. Br J Clin Pharmacol. 2012;74(4):573–80.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Holland R, Desborough J, Goodyer L, Hall S, Wright D, Loke YK. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. Br J Clin Pharmacol. 2008;65(3):303–16.

    Article  PubMed  Google Scholar 

  11. Imfeld-Isenegger TL, Soares IB, Makovec UN, Horvat N, Kos M, van Mil F, et al. Community pharmacist-led medication review procedures across Europe: Characterization, implementation and remuneration. Res Social Adm Pharm. 2020;16(8):1057–66.

    Article  PubMed  Google Scholar 

  12. Fraeyman J, Foulon V, Mehuys E, Boussery K, Saevels J, De Vriese C, et al. Evaluating the implementation fidelity of New Medicines Service for asthma patients in community pharmacies in Belgium. Res Social Adm Pharm. 2017;13(1):98–108.

    Article  PubMed  Google Scholar 

  13. Lelubre M, Wuyts J, Maesschalck J, Duquet N, Foubert K, Hutsebaut C, et al. Implementation study of an intermediate medication review in Belgian community pharmacies. Res Social Adm Pharm. 2019;15(6):710–23.

    Article  PubMed  Google Scholar 

  14. Rijksinstituut voor Ziekte- en Invaliditeitsverzekering. Verklarende nota bij de 37ste wijzigingsclausule bij de overeenkomst tussen de apothekers en de verzekeringsinstellingen. Brussel2017 [accessed 2020 April 1]. Available from: https://www.riziv.fgov.be/SiteCollectionDocuments/overeenkomst_apothekers_Wijzigingsclausule37.pdf.

  15. Robberechts A. Van medicatieschema naar medication review. Antwerps Farmaceutisch Tijdschrift. 2018;3(20):1.

  16. De Silverman. Qualitative research / edited by David Silverman. 4: ed. Los Angeles: SAGE; 2016.

    Google Scholar 

  17. Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–57.

    Article  PubMed  Google Scholar 

  18. Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie. Medicatiebeoordeling Den Haag KNMP Apothekersorganisatie; 2013 [accessed 2020 April 1]. Available from: https://www.knmp.nl/patientenzorg/medicatiebewaking/medicatiebeoordeling.

  19. Houghton C, Murphy K, Meehan B, Thomas J, Brooker D, Casey D. From screening to synthesis: using nvivo to enhance transparency in qualitative evidence synthesis. J Clin Nurs. 2017;26(5–6):873–81.

    Article  PubMed  Google Scholar 

  20. Kerr C, Nixon A, Wild D. Assessing and demonstrating data saturation in qualitative inquiry supporting patient-reported outcomes research. Expert Rev Pharmacoecon Outcomes Res. 2010;10(3):269–81.

    Article  PubMed  Google Scholar 

  21. De Backere F, Bonte P, Verstichel S, Ongenae F, De Turck F. Sharing health data in Belgium: A home care case study using the Vitalink platform. Inform Health Soc Care. 2018;43(1):56–72.

    Article  PubMed  Google Scholar 

  22. Ezra O, Toren A, Tadmor O, Katorza E. Secure Instant Messaging Application in Prenatal Care. J Med Syst. 2020;44(4):73.

    Article  PubMed  Google Scholar 

  23. Kwint HF, Faber A, Gussekloo J, Bouvy ML. Completeness of medication reviews provided by community pharmacists. J Clin Pharm Ther. 2014;39(3):248–52.

    Article  CAS  PubMed  Google Scholar 

  24. Hatah E, Braund R, Duffull S, Tordoff J. General practitioners’ perceptions of pharmacists’ new services in New Zealand. Int J Clin Pharm. 2012;34(2):364–73.

    Article  PubMed  Google Scholar 

  25. Van C, Mitchell B, Krass I. General practitioner-pharmacist interactions in professional pharmacy services. J Interprof Care. 2011;25(5):366–72.

    Article  PubMed  Google Scholar 

  26. Weir KR, Naganathan V, Rigby D, McCaffery K, Bonner C, Trevena L, et al. Home medicines reviews: a qualitative study of GPs. Aust J Prim Health. 2019;26(1):24–30.

    Article  Google Scholar 

  27. Bryant L, Coster G, McCormick R. Community pharmacist perceptions of clinical medication reviews. J Prim Health Care. 2010;2(3):234–42.

    Article  PubMed  Google Scholar 

  28. Hatah E, Braund R, Duffull SB, Tordoff J. General practitioners’ views of pharmacists’ current and potential contributions to medication review and prescribing in New Zealand. J Prim Health Care. 2013;5(3):223–33.

    Article  PubMed  Google Scholar 

  29. Disalvo D, Luckett T, Bennett A, Davidson P, Agar M. Pharmacists’ perspectives on medication reviews for long-term care residents with advanced dementia: a qualitative study. Int J Clin Pharm. 2019;41(4):950–62.

    Article  PubMed  Google Scholar 

  30. Navti B, Apampa B. Pharmaceutical care services to people living with dementia in care homes: A qualitative study of community pharmacists’ perceptions. Dementia (London). 2019;18(6):2282–302.

    Article  Google Scholar 

  31. Costa D, Van C, Abbott P, Krass I. Investigating general practitioner engagement with pharmacists in Home Medicines Review. 2015;29(5):469–75.

    Google Scholar 

  32. Kennelty KA, Chewning B, Wise M, Kind A, Roberts T, Kreling D. Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists’ perspectives. Res Social Adm Pharm. 2015;11(4):517–30.

    Article  PubMed  Google Scholar 

  33. Houle SK, Grindrod KA, Chatterley T, Tsuyuki RT. Paying pharmacists for patient care: A systematic review of remunerated pharmacy clinical care services. Can Pharm J (Ott). 2014;147(4):209–32.

    Article  Google Scholar 

  34. Niquille A, Lattmann C, Bugnon O. Medication reviews led by community pharmacists in Switzerland: a qualitative survey to evaluate barriers and facilitators. Pharm Pract (Granada). 2010;8(1):35–42.

    Article  Google Scholar 

  35. France FR. eHealth in Belgium, a new “secure” federal network: role of patients, health professions and social security services. Int J Med Inform. 2011;80(2):e12–6.

    Article  PubMed  Google Scholar 

  36. De Bock L, Tommelein E, Baekelandt H, Maes W, Boussery K, Somers A. The Introduction of a Full Medication Review Process in a Local Hospital: Successes and Barriers of a Pilot Project in the Geriatric Ward. Pharmacy (Basel, Switzerland). 2018;6(1):21.

    Google Scholar 

  37. De Bock L, Tommelein E, B, t H, Maes W, Boussery K, et al. The Introduction of a Full Medication Review Process in a Local Hospital: Successes and Barriers of a Pilot Project in the Geriatric Ward. Pharmacy (Basel).6(1).

  38. Redmond P, Carroll H, Grimes T, Galvin R, McDonnell R, Boland F, et al. GPs’ and community pharmacists’ opinions on medication management at transitions of care in Ireland. Fam Pract. 2016;33(2):172–8.

    Article  PubMed  Google Scholar 

  39. Dhillon AK, Hattingh HL, Stafford A, Hoti K. General practitioners' perceptions on home medicines reviews: a qualitative analysis. BMC Fam Pract 16:16.

  40. Latif A. Community pharmacy Medicines Use Review: current challenges. Integr Pharm Res Pract. 2017;7:83–92.

    Article  PubMed  Google Scholar 

  41. Snell R, Langran T, Donyai P. Patient views about polypharmacy medication review clinics run by clinical pharmacists in GP practices. Int J Clin Pharm. 2017;39(6):1162–5.

    Article  PubMed  Google Scholar 

  42. Cardosi L, Hohmeier KC, Fisher C, Wasson M. Patient Satisfaction With a Comprehensive Medication Review Provided by a Community Pharmacist. J Pharm Technol. 2018;34(2):48–53.

    Article  PubMed Central  PubMed  Google Scholar 

  43. White L, Klinner C, Carter S. Consumer perspectives of the Australian Home Medicines Review Program: benefits and barriers. Res Social Adm Pharm. 2012;8(1):4–16.

    Article  PubMed  Google Scholar 

  44. Carter SR, Moles R, White L, Chen TF. Exploring patients’ motivation to participate in Australia’s Home Medicines Review program. Int J Clin Pharm. 2012;34(4):658–66.

    Article  PubMed  Google Scholar 

  45. Mast R, Ahmad A, Hoogenboom SC, Cambach W, Elders PJ, Nijpels G, et al. Amsterdam tool for clinical medication review: development and testing of a comprehensive tool for pharmacists and general practitioners. BMC Res Notes. 2015;8:642.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Niquille A, Bugnon O. Relationship between drug-related problems and health outcomes: a cross-sectional study among cardiovascular patients. Pharm World Sci. 2010;32(4):512–9.

    Article  PubMed  Google Scholar 

  47. Leikola SN, Virolainen J, Tuomainen L, Tuominen RK, Airaksinen MS. Comprehensive medication reviews for elderly patients: findings and recommendations to physicians. J Am Pharm Assoc. 2012;52(5):630–3.

    Article  Google Scholar 

  48. Kolhatkar A, Cheng L, Chan FK, Harrison M, Law MR. The impact of medication reviews by community pharmacists. J Am Pharm Assoc. 2016;56(5):513–20.e1.

    Article  Google Scholar 

Download references

Acknowledgements

We would like to thank all local pharmacists and GPs who participated in this study and Bronwen Martin for her critical reading of the manuscript.

Funding

This work was supported by the Royal Pharmacists Association of Antwerp (KAVA).

Conflicts of interest

The authors declare that they have no conflicts of interest related to this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Anneleen Robberechts.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Robberechts, A., De Petter, C., Van Loon, L. et al. Qualitative study of medication review in Flanders, Belgium among community pharmacists and general practitioners. Int J Clin Pharm 43, 1173–1182 (2021). https://doi.org/10.1007/s11096-020-01224-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-020-01224-9

Keywords

Navigation