Implementation of type 3 medication review in Flanders : obstacles and opportunities
Type 3 medication reviews (MR3s) represent a collaborative effort between healthcare providers and patients, aiming to optimize medication therapy and promote better health outcomes. This thesis delves into the sustainable integration of MR3s in Flemish community pharmacies, exploring aspects such as successful implementation, quality assessment, challenges faced, and effective strategies for seamless integration into the healthcare system. The thesis begins with a clear introduction, breaking down the multiple complex definitions, categories, and historical development of MR practices. The thesis subsequently expands on the perspectives gathered from community pharmacists and general practitioners (GPs) involved in the MR3 pilot projects. These insights, using a qualitative research methodology, unveil a noticeable eagerness and readiness among healthcare professionals for the incorporation of MR3 in practice. The project faced certain barriers for future implementation, such as a shortage of time and a lack of commensurate compensation. Moreover, the perspectives of patients who participated in the pilot project were also examined though qualitative research. Although most patients were enthusiastic about this new service, a lack of patients’ understanding of the whole process was also observed. Improved communication between pharmacists and GPs to inform patients about the goals and components of this medication review type is necessary, leading to enhanced efficiency. The thesis emphasizes the importance of quality assessment for ensuring the effectiveness and sustainability of MR3 interventions. Initially, four target groups were surveyed using an electronic questionnaire to pinpoint key quality criteria for a qualitative MR3. There was widespread agreement about the hierarchy of the quality assessment criteria for MR3s. Minor differences were related to the experience of the participants. Based on these findings and a few suggested criteria, the BRANT-MERQS (Brussels Antwerp Medication Review Quality Score) scoring table, a quality assessment instrument for MR3, was developed. This scoring tool was evaluated in two subprojects, namely in patients with rheumatoid arthritis (subproject 1, RA) and in patients with type 2 diabetes (subproject 2, T2DM). The results demonstrated the feasibility of MR3 quality assessment through a scoring system. However, this study also unveiled the tool's current imperfections and highlighted the ongoing need for refinement, something expected of a new service in an implementation phase. In conclusion, this research not only demonstrates the feasibility and enthusiasm surrounding MR3 but also offers nuanced insights and pragmatic recommendations reinforcing clinical practice and improving patient care through the judicious integration of MR3s with quality assurances into the healthcare landscape.
Antwerp : University of Antwerp & Vrije Universiteit Brussel , 2024
182 p.
Supervisor: De Loof, Hans [Supervisor]
Supervisor: De Meyer, Guido [Supervisor]
Supervisor: Steurbaut, Stephane [Supervisor]
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Creation 22.04.2024
Last edited 30.04.2024
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