Article Text
Abstract
Aim To explore the role of primary care pharmacists in the management of chronic illnesses in young people aged 10–24 years.
Methods Systematic search of four databases: MEDLINE, EMBASE, Cochrane Library and CINAHL using MeSH (Medical Subject Heading) and Emtree terms covering three main themes, namely, pharmacist, young people and chronic illnesses. Inclusion criteria: articles identifying the role of primary care pharmacists in the management of chronic illness and its acute manifestations in young people aged 10–24 years. Exclusion criteria: articles referring to the hospital, secondary care setting. Chronic conditions such as disability. Acute disease. Conference abstracts, letters and case studies.
Results Eight relevant articles were identified from different countries UK(3), USA(3), Netherlands(1) and Chile(1). All of the articles made reference to community pharmacists only and did not include information on pharmacists working in any other area of primary care (e.g. general practice). Seven of the articles identified included original research studies (1 observational, 2 survey, 2 qualitative interview, 2 intervention). The remaining article was a literature review. The interventional studies utilised pharmacists to manage specific chronic illnesses (i.e. asthma and metabolic disease). Both showed significant results in terms of improvement of a young person’s quality of life and improvement in their knowledge about their disease and its treatment. The research studies gathered the opinions of pharmacists (3) and young people (1) based on their experiences. The most prominent issue arising from the research into pharmacist opinion was the lack of direct communication with the young person because of parents collecting prescription items. In one study,1 around half of participants stated this to be the main cause of medication-related problems, which in the main were non-adherence, in young people. Community pharmacists identified many roles that they felt were of high priority to their practice when dealing with young people. These included supporting young people to develop generic health care skills, build trusting relationships directly with young people, counselling with affirmation on the necessity and benefits of adhering to their medicine regimens, helping young people to find credible online health information and use digital media for educational or reminder purposes, transferring information effectively across care interfaces and provision of specialist services.1 2
Conclusion There is a lack of published literature regarding the role of pharmacists in the management of chronic illness in young people. Where primary care pharmacists have managed chronic illnesses in this patient population, they have been community-based and have had a positive impact on patient outcomes. Pharmacists feel that they have a role to play in supporting young people with chronic illness and have identified many areas where they can provide additional services and support. However, many pharmacists perceive a fundamental communication barrier which hinders provision of this support i.e. lack of access to the patient. This suggests that given the appropriate training and access to these patients pharmacists could have a positive impact on patient outcomes. Further research is necessary to provide more evidence that primary care pharmacists could be further utilised in supporting young people with their medications.
References
Koster E, Philbert D, Winters N, et al. Medication adherence in adolescents in current practice: community pharmacy staff’s opinions. International Journal of Pharmacy Practice, 2015;23(3):221–224.
Gray N, Shaw K, Smith F, et al. The Role of Pharmacists in Caring for Young People With Chronic Illness. Journal of Adolescent Health, 2017;60(2):219–225.