A NEW CARE DELIVERY MODEL

DRUG REFILL SERVICES (DRS) IN A BUSY ENDOCRINE CLINIC OF A TERTIARY MEDICAL CENTRE

Abstract

INTRODUCTION
A stable and trustworthy healthcare practitioner-patient relationship is of critical importance in chronic care delivery. The quality of outpatient health care services in the public sector is often limited by physician manpower which might be enhanced by a new care delivery model— Drug Refill Services (DRS) involving pharmacists taking on an active role in patient care in the outpatient clinics.

METHODOLOGY
DRS was delivered via a doctor-pharmacist team-based cocare delivery model. Patients fulfilling the DRS inclusion criteria would see a doctor at a more prolonged duration as compared to the usual non-DRS routine, with added regular interim consultations by pharmacists. Thereby, the doctor would be allowed more time to spend on other new and/or complex cases.

RESULTS
Since the inception of the DRS program in January 2018, 200 patients with endocrine diseases fulfilling the inclusion criteria were recruited until December 2022. A total of 669 pharmacist-DRS consultations (658 DRS clinic attendances and 11 telephone interviews during the COVID-19 pandemic) were recorded. Follow-up durations by doctors became longer, from 28 weeks to 62 weeks on average. The total number of pharmacist consultations with drugrelated problems identified was 119 (17.7%). The number of episodes when a doctor was consulted by a pharmacist during pharmacist consultations was 18 (2.7%). The DRS led to enhanced drug compliance, reduced frequency of doctor visits, and lengthened follow-up duration by doctors.

CONCLUSION
With the help of pharmacists, the DRS has successfully improved the quality of patient care and lengthened the doctors’ visit follow-up duration of stable patients with diabetes, thereby releasing the capacity for doctors to see more new/complex patients with endocrine diseases every week in the busy outpatient diabetic clinic in the public sector.