The CombiConsultation for patients with diabetes, COPD and cardiovascular diseases: Evaluation of interventions and personal health-related goals

Valérie A M Meijvis; Mette Heringa; Henk-Frans Kwint; Niek J de Wit; Marcel L Bouvy

doi:10.1016/j.sapharm.2023.04.118

The CombiConsultation for patients with diabetes, COPD and cardiovascular diseases: Evaluation of interventions and personal health-related goals

Res Social Adm Pharm. 2023 Jul;19(7):1054-1060. doi: 10.1016/j.sapharm.2023.04.118. Epub 2023 Apr 17.

Authors

Valérie A M Meijvis¹, Mette Heringa², Henk-Frans Kwint³, Niek J de Wit⁴, Marcel L Bouvy⁵

Affiliations

¹ SIR Institute for Pharmacy Practice and Policy, 2331 JE, Leiden, the Netherlands; Department of Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands. Electronic address: v.meijvis@sirstevenshof.nl.
² SIR Institute for Pharmacy Practice and Policy, 2331 JE, Leiden, the Netherlands. Electronic address: m.heringa@sirstevenshof.nl.
³ SIR Institute for Pharmacy Practice and Policy, 2331 JE, Leiden, the Netherlands. Electronic address: h.f.kwint@apotheekstevenshof.nl.
⁴ Department of General Practice, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands. Electronic address: N.J.deWit@umcutrecht.nl.
⁵ Department of Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands. Electronic address: M.L.Bouvy@uu.nl.

PMID: 37095031
DOI: 10.1016/j.sapharm.2023.04.118

Abstract

Background: The CombiConsultation is a consultation with the community pharmacist for patients with diabetes, COPD and/or cardiovascular disease (CVD), aligned with the annual or quarterly consultation with the practice nurse (PN) or general practitioner (GP). The consultation is focused on the personal health-related goals of the patient.

Objectives: To assess the number and types of personal health-related goals, drug-related problems (DRPs) and interventions identified by pharmacists during a CombiConsultation and to investigate which patients can benefit most from such consultation.

Method: Twenty-one Dutch community pharmacies and associated GP practices were included in the CombiConsultation study. CombiConsultations were performed, involving patients with diabetes, COPD and/or (at risk of) CVD. The pharmacists set health-related goals together with the patients and identified DRPs. The number and types of personal health-related goals, DRPs and interventions were analysed. Associations between patient characteristics and the identification of at least one DRP were analysed by multivariate regression analysis.

Results: In 834 patients (49% men, mean age: 70 years), 939 DRPs were identified, mostly (potential) side effects (33%), undertreatment (18%) and overtreatment (14%). In 71% of the patients, one or more DRPs were found, with a median of one DRP per patient. Pharmacists proposed 935 recommendations, of which 72% were implemented. DRPs were found more often in patients using a higher number of drugs for chronic conditions. A total of 425 personal health-related goals were set, of which 53% were (partially) attained.

Conclusion: The CombiConsultation can be used as a compact health service contributing to safe and effective use of medication for patients with diabetes, COPD and/or (at risk of) CVD, also in patients under 65 or with less than 5 medications in use. The output of the CombiConsultation reflects its characteristics.

Keywords: CombiConsultation; Community pharmacist; General practice; Pharmaceutical care; Primary care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cardiovascular Diseases* / drug therapy
Diabetes Mellitus* / drug therapy
Drug-Related Side Effects and Adverse Reactions*
Female
Goals
Humans
Male
Pharmacists
Pulmonary Disease, Chronic Obstructive* / drug therapy