Home Healthcare Services’ Clinical Pharmacists′ patient-centered interventions during the COVID-19 outbreak

Abstract

Background: Home Health Care Services is a non-residential long-term care facility, part of Hamad Medical Corporation. It serves around 2,700 patients, the majority of which are elderly, with multiple co-morbidities and polypharmacy, and subsequently, an increased risk of drug-related problems and inappropriate medication use.1 The clinical pharmacists’ ultimate focus is to provide effective pharmaceutical care to improve health outcomes and quality of life for these patients. Methods: As most clinical and medical services were delivered via telephone consultations, pharmacists were visiting elderly patients at home for Medication Therapy Management2,3 taking appropriate measures to protect everyone. Their interventions included; medication reconciliation with appropriate identification of medication discrepancies, assessing compliance to prescribed medications ensuring safe and effective medication use; educating patients/families/caregivers about appropriate indication, dose, frequency, safe handling, and disposal, considering deprescribing of some medications that could negatively impact health outcomes using shared decision making in a very simple and raw language free from medical jargons, and recognizing any medications related problems (Figure 1). Results: Between January 2020 and December 2020, around 1,000 home visits were conducted, and 865 phone call consultations took place. The main challenges that were encountered were the language barriers of some caregivers as well as difficulty tracking some medications that have no clear indication. As a result, this work has created a long-term vision for aspirational and forward-thinking pharmacy practice models that resulted in improved clinical outcomes as well as increased patients’ and their caregiver's satisfaction about the clinical pharmacy services in Qatar (Figure 2). Conclusion: Clinical pharmacists played a major role during the COVID-19 pandemic as part of the multidisciplinary team providing unique, patient-centered, and high-quality pharmaceutical care. Through their visits and elderly patient and caregivers education, clinical pharmacists contributed significantly to keeping home healthcare elderly patients safe and well looked after despite the pandemic.