The Perceived Feasibility of a Pill Card in Simplifying Medication Regimens in Community Pharmacies- Patient, Pharmacist and Student Pharmacist Perspectives

Objective: This study explores the feasibility of adopting a pill card service for simplifying complex medication regimens in a community pharmacy setting. Conceptually, the study seeks to follow a concordance approach between the community pharmacists and patients working together to schedule an optimal medication regimen.;Methods:This study was conducted by employing a mixed methods, multi-modal strategy pertaining to each of the stakeholders. A purposive sample of older adults taking >5 prescription medications daily was selected from two senior centers. These patients were qualitatively interviewed. Fourth year student pharmacists (n= 133) were trained to perform the pill card service during their APPE rotations in community pharmacies. Their perspectives were collected using a 29-question survey. The perspective of the newly practicing pharmacists were collected by using the same survey in Pharm D alumni who had graduated in 2013 (n=123). All quantitative data were analyzed using STATA 13.0 and all the qualitative data were coded and compiled in NVIVO 10 software.;Principal Findings: 16 older adults were interviewed until saturation was reached. The number of chronic diseases ranged from 4-9 per patient and all the patients were taking medications for some form of heart disease. Major themes includes high autonomy and pride in self-management and, a sense of "looking forward" to manage medications. Most patients expressed that they did not know that the pharmacist could help them in simplifying their medication schedules using the pill card. The appeared busyness of a community pharmacist was considered as a barrier to seek such a service.;The intention to adopt the pill card was significantly predicted by the constructs of perceived patient benefit (p=0.01), perceived technical benefit (p=0.004), perceived social benefit (p=0.00) and perceived compatibility (p=0.00). Qualitative interviews with students unveiled novel ways in which the pill card service could be adopted such as the pharmacy dispensing software could produce electronic versions of the pill card, delegating a part of the pill card service responsibility to the pharmacy technicians, and potentially as an adjunct to weekly pill-box service filling.;A total of 22/123 (18%) surveys were returned from newly practicing pharmacists. Descriptive statistics on each of constructs showed that newly practicing pharmacists scored positively on all the constructs, except the construct of technical benefit.;Conclusion: The pill card service was found to be a feasible intervention to help simplify complex regimens of multi-morbid patients with the help of a community pharmacist. Adoption of the pill card service can be feasibly facilitated through training student pharmacists about the potential of this unique pill card service before they enter practice.