24/07/2013

LINKING ELECTRONIC PRESCRIPTIONS TO PHARMACEUTICAL MANAGEMENT IS KEY TO IMPROVE CHRONIC PATIENT CARE

· The MEDAFAR Project, fostered by SEMERGEN, ESTEVE and FUNDACIÓN PHARMACEUTICAL CARE, improves communication between primary care physicians and community pharmacists by using electronic prescription transmission systems


· To this end, the fifth phase of this project has defined messages that group together real-life situations likely to generate referrals between physicians and pharmacists in the context of chronic patient pharmacotherapy


· This phase will be concluded with a pilot test conducted in pharmacies and health care centers of the Valencian Community, to be carried out in the fourth quarter of the current year

The objective of the MEDAFAR Project, fostered by the Spanish Society of Primary Care Physicians (SEMERGEN), ESTEVE and FUNDACIÓN PHARMACEUTICAL CARE, is to improve communication between primary care physicians and community pharmacists to attain optimal pharmaco-therapeutic care in chronic patients. To this end, the fifth phase of this project will include predefined messages in the e-prescribing two-way transmission systems in case of specific referral situations previously agreed between these two groups of healthcare providers.

Physician-pharmacist coordination is key to offer optimal health care to patients and to ensure an effective and safe use of drugs. For this coordination to be efficient, a common language is essential to allow dynamic and efficient classification of referrals among physicians and pharmacists.

This is precisely what the fourth and fifth phases of MEDAFAR have developed: a classification that defines and groups together situations likely to generate referrals between physicians and pharmacists in the context of patient pharmacotherapy, as well as a list of coded messages to standardize communication between these two groups of professionals.

MEDAFAR's Classification of Pharmaco-Therapeutic Referrals ―prepared and validated throughout the previous phases of the project― has been designed to be intuitive and easy to use. Also, it is based on real-life situations likely to be encountered both at the physician's office and at the pharmacy, and abides by the rules of the International Classification of Primary Care (ICPC). On the whole, MEDAFAR has identified 28 possible situations likely to generate referrals, grouped in 4 different categories: Need, Safety, Efficiency, and Health Education. These, in turn, have a two-digit code: one letter for the category of the problem and one number for the specific case referred.

These codes will be included in the e-prescribing programs so that the pharmacist may use them to refer a patient and the physician knows what to do and why the patient is referred. This two-way communication allows both the physician and the pharmacist to send and receive messages, thereby facilitating communication of relevant data in specific situations to improve chronic patient care.

MEDAFAR's phase V will be concluded with a three-month pilot functionality test conducted at the end of this year in pharmacies and health care centers of the Valencian Community ―in the province of Castellón― and further implemented in all autonomous communities where authorities wish to enforce it.

The development of this project involved the creation of a Steering Committee formed by professionals from each of the three entities concerned: SEMERGEN, ESTEVE and FUNDACIÓN PHARMACEUTICAL CARE, as well as Work Groups formed by physicians and pharmacists from Asturias, Catalonia, Extremadura, Galicia, Madrid, and the Valencian Community. These will be in charge of developing the composition of the coded message communication standard.

MEDAFAR is a five-phase project. Phase I included agreeing criteria for referral to the physician in case of asthma and blood hypertension. This was published in phase II, and phase III included testing this consensus in a number of pharmacies and its corresponding health care centers. Then, situations likely to generate referrals due to pharmacotherapy-related problems were classified in phase IV.

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