Background Primary healthcare has a significant role in promoting the rational use of medicines. Finland’s health and social services reform aims to strengthen primary healthcare services and prevent diseases with multi-professional teamwork. Pharmacists should be involved in the development of the medication management process in primary care.
Purpose The aim was to identify risk factors in the medication management process in primary care to target a clinical pharmacist’s work tasks which could improve medication safety.
Material and Methods This study was conducted in public health centers in Espoo, Southern Finland. First, a medication safety audit tool for primary healthcare was developed based on the audit tool for hospitals. Second, medication safety audits were conducted at four public health centers. In the audits, the pharmacotherapy plan and the medication management process were observed, and the renewal process of electronic prescriptions was evaluated. Based on the audit results, a proposal was made on the key development areas of the medication management process and the role description of the clinical pharmacist.
Results The key development areas identified with the medication safety audits were 1) updating and implementing the unit-based pharmacotherapy plans, 2) standardizing the medication reconciliation protocol, 3) documenting and utilizing the patient‘s pharmacotherapy plan, 4) standardizing the protocol for reviewing and documenting drug allergies, and 5) a need for medication safety protections in emergency care services. Furthermore, the lack of up-to-date medicines information when renewing electronic prescriptions was identified, as most of the prescriptions are renewed outside physicians’ appointments without direct contact with a patient. The suggested core task areas of the primary care clinical pharmacist at public health centers to improve medication safety were: 1) pharmacotherapy plan and quality control; 2) medication risk management; 3) development of the medication management process; and 4) other work tasks related to clinical pharmacy.
Conclusions With medication safety audits, it was possible to identify the medication safety risks in the medication management process and prioritize a clinical pharmacist’s work tasks that improve medication safety. The identified development areas and medication safety work would suit the primary care clinical pharmacist’s role.
Conflict of Interest No conflict of interest
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