(P-175) Community Pharmacists Managed Patient Safety Program with Minimal Patient Contact for Elderly Patients in Ajman, United Arab Emirates

Background: Ongoing Covid-19 containment measures restrict elderly patients to visit healthcare facilities and predispose them to experience more drug therapy related problems (DTRPs). Though community pharmacy practice is not well developed in United Arab Emirates, exploring community pharmacists (CPs) involvement in enhancing safe medicine use among elderly can be valuable.

Objectives: This pilot study, part of a proposed large trial, assessed the impact of a CP managed patient safety program with minimal patient contact on improving patient safety and adherence among elderly patients.

Methods: A prospective interventional study with a pretest-posttest single group design was conducted in two conveniently selected community pharmacies in Ajman, UAE after obtaining ethical approval. Two CPs, one each from the two pharmacies were trained by the research team on DTRP identification and resolving through direct visit and Zoom meeting. Specific inclusion criteria (elderly, >50 yrs and 3 or more medications) were applied. CPs manually (at the time of enrollment) and telephonically monitored patients over three months following the existing social distancing procedures and performed medicine use review, intervention and education. Patients were assessed using Medication Adherence Rating Scale (MARS) questionnaire for adherence at 0 and 90 days.

Results: Ten patients (male 6 and female 4) were randomly recruited with mean age 62.5±10.16 years with 22 comorbidities (hyperlipidemia 8, type 2 diabetes 6, hypertension 5 etc) and 63 medications (statins 8; aspirin 6, diuretics 5 etc). Interventions provided were counseling on importance of adherence, setting of alarm in smartphone as per dosage schedule, convincing to physician follow-up, instructing not to take all medications together and rather taking medicines at correct time, frequency and duration, among others. Six DTRPs were identified and mitigated by the CPs and were lack of adherence in two patients (due to side effects and unable to buy medications), adverse drug reactions (n=2); statin induced muscle pain in one patient and bitter taste attributable to multiple medications in another patient, unnecessary medication (n=1), drug interactions (n=1), untreated condition (acid reflux) requiring physician referral. Postintervention score demonstrated improvements in medication adherence. Challenges were mainly lack of time among CPs and unavailability of complete patient data.

Conclusions: Even with minimal patient contact CPs can improve adherence, identify and mitigate DTRPs in elderly people during Covid 19 pandemic and maybe even post pandemic era.