Background: Community pharmacies can contribute to safer medication use among patients in municipal care by providing education on medication handling to staff in nursing homes, home care, and residential facilities. To evaluate the outcomes of such education, Danish researchers have recently developed quality indicators comprising 54 items divided into six groups related to the quality of medication instructions (2 groups), patients’ medication lists (1 group), medication dispensing (1 group), and medication administration (2 groups) in a municipal institution.
Purpose: This study aimed to evaluate the education provided by community pharmacists on medication handling to municipal staff using the recently developed quality indicators as outcomes. We investigated changes in the quality of medication handling within a municipality before and after the education based on quality indicator scores, as well as the feasibility of indicator scoring from the pharmacists’ perspective.
Method: Pharmacists scored each item before and after the education, giving a value of 1 ("complied") or 0 (“not complied”). Subsequently, aggregated scores indicating compliance with all items within a group were formed. Before-after changes were assessed using both individual and aggregated indicator scores. Changes in binary scores regarding medication instructions were assessed using McNemar's tests. Changes in the scores concerning patients’ medication lists, dispensing, and administration were assessed using paired t-tests after binary scores were transformed into a scale by averaging it across all patients in the institution. After the post-education scoring, pharmacists additionally evaluated the feasibility of the scoring process on a scale ranging from 1 to 10 and provided suggestions for indicator improvement.
Results: Staff from a total of 19 community pharmacies provided education and scored indicators at various institutions in 20 municipalities in Denmark from November 2022 to April 2023. Significant improvements were observed for six individual item scores, one out of two aggregated scores concerning medication instructions, and an aggregated score concerning medication dispensing (one-sided p < 0.05). The feasibility median was 8 for the medication list indicator set and 9 for the other three indicator sets. Suggestions for improvement mainly addressed indicator comprehensibility, as well as the time and infrastructure needed for their scoring.
Conclusion: The education provided by community pharmacists to municipal staff about medication handling improved the quality of medication instructions as well as the quality of medication dispensing in municipal institutions. The developed quality indicators can be successfully used as outcomes to evaluate similar education if time and relevant infrastructure for indicator scoring are warranted.