Pharmacy Of Your Choice Scheme : pharmaceutical service review

Abstract

In Malta, patients suffering from chronic diseases are entitled to receive free medicines through the government scheme, Pharmacy Of Your Choice (POYC). This scheme is an opportunity for community pharmacists to become coordinators in chronic disease management. This research study aimed to review the implementation and service provision of POYC by determining the infrastructural and workload changes of POYC in community pharmacies, to assess the quality standard of services provided through the POYC scheme, to identify the effects of facilitating and impeding factors related to POYC implementation and to identify the types of interventions pharmacists make when providing POYC services. A mixed-method approach was adopted. A self-administered questionnaire was used to obtain data from 107 community pharmacists and 153 POYC-registered patients recruited via convenience sampling, accessing medicines from four community pharmacies. The questionnaire consisted of five-point Likert scale questions where differences in responses were analyzed using one-way ANOVA. Semi-structured interviews were carried out with POYC stakeholders and data collected was subjected to content analysis. Fault Tree Analysis (FTA) was conducted with patients’ failure to receive the medication as the top-level fault. Pharmacists agreed that POYC is an opportunity for an extended role in primary health care (n=98; 92%). This finding was supported by the high expression of interest by pharmacists and patients for possible POYC clinical services including new medicines review (pharmacists: n=103; 96%; patients: n=151; 99%) and health screening management on chronic diseases (pharmacists: n=103, 96%; patients: n=142; 93%). Pharmacists recognized their role in public health during crisis situation by serving as direct point of information on infection prevention and control measures (n= 107; 100%). The key driver identified by pharmacists to POYC activities during the pandemic was their open and good communication with POYC Unit (n=83; 78%) whereas the barrier included the inadequate supply of medicines they have received from POYC (n=86; 80%). This identified barrier of lack of medicine supply from POYC was addressed and mitigated by the pharmacists through their close monitoring and allocation of stock. This pharmacists’ intervention translated to patients’ favorable experience during the pandemic, expressing they have received adequate supply of their entitled medicines (n=147; 96%). Data collected from the interview with POYC stakeholders identified issues in medicine management such as in procurement, distribution and utilization monitoring. The FTA revealed 25 events that may lead to patient’s failure to receive medication. The study highlighted the unique pharmacists’ interventions within POYC scheme ensuring that patients have consistent access and supply of free medicines especially in crisis situations such as the pandemic whilst providing medicines management services.