The impact of introducing a satellite dispensary service at an outpatient HIV clinic

Abstract

BackgroundStudies have demonstrated the potential impact of pharmaceutical services in HIV care [1]. We sought to extend HIV pharmacy services at the Dean Street outpatient HIV/GUM clinic to improve efficiency and enhance client satisfaction. The pharmacy team was expanded and a satellite dispensary was opened in the clinic. This project compares the new dispensary service with the previous one offered.MethodComparisons were made between the pre‐ and post‐change period across a range of pharmaceutical services provided and patient satisfaction feedback. Medicine‐related interventions, repeat prescription requests, waiting and dispensing times were recorded. Service satisfaction questionnaires were designed for patients to quantify aspects of service provision.ResultsTypes of interventions remain broadly similar (p=0.353), with an increase in the daily number of interventions (p=0.0038) and a decrease in time spent per intervention (p=0.006) in the new service delivery model. A greater dispensing time (p=0.035, p=0.001) and time per item (p=0.043, p=0.002) for prescriptions with related queries was seen across both periods. However, the time taken to dispense prescriptions remained similar pre‐ and post change (p=0.8). The patient satisfaction survey had a series of statements relating to pharmacy services; there was a stronger association with patient satisfaction seen for the provided services during the post‐change period. The number and types of repeat prescription requests remain unchanged (p=0.342); however, patient prescription requests were completed more efficiently post‐change (mean time 5.4 minutes) as compared to pre‐change (mean 12.6 minutes; p = 0.001). There was also a significantly lower rate of FP10 prescriptions issued in the post‐change period due to a greater choice of available medications.ConclusionThe care contributions of HIV pharmacists to a multidisciplinary HIV clinic providing patient‐centred care were measured before and after the introduction of a satellite dispensary service. The expanded pharmacy service has increased efficiency by completing more tasks in less time and increased access to medications for patients. Its focus is dealing with patient‐related queries and providing support for the patients seen at the clinic.