Seamless care between community pharmacy and pharmacy of your choice service

Abstract

Malta's Pharmacy of Your Choice (POYC) scheme provides free medicine and medical devices. Improving care transitions across various healthcare settings is essential for improving patient outcomes. This study aimed to reduce fragmentation and maximise the efficient use of POYC services using a three-phase mixed methodology. Phase 1 was the development of flowcharts illustrating the patient’s journey within the POYC scheme. Phase 2 was a focus group discussion (FGD) with healthcare providers in the POYC scheme. Fifteen were initially recruited via convenience sampling; to increase participants, 9 organisations were emailed; 7 accepted; however, only 3 joined. Phase 3 was questionnaire dissemination to POYC patients. Invitation emails were sent to 131 community pharmacies; 17 accepted; however, only 5 participated generating 39 responses. To increase responses, 13 community pharmacists were given hard copies of the questionnaire which generated 70 responses. In phase 1, six flowcharts were developed outlining the general processes of POYC. In phase 2, the FGD revealed fifteen major themes related to healthcare providers' perceptions of the current system, familiarity and gaps in the flowcharts, knowledge and experiences in the POYC system, barriers such as medication supply challenges, care continuity issues, and communication challenges, and recommendations for improving the POYC system. In phase 3, 109 POYC patients answered the questionnaire. Participants have adequate knowledge [mean rating score (MRS) 3.82 ± 1.1] of registering with POYC and moderate knowledge of logistics (MRS 3.28 ± 1.25) and renewal of entitled documents (MRS 3.03 ± 1.32). Sixty-six (60.6%) need more information about POYC services. Forty-eight (44%) waited 8-14 days to receive the medications they were first prescribed, while 50 (45.9%) received newly added medications within 2–7 days. Eighty-one (74.3%) participants faced disruptions, mainly due to stock shortages. Sixty-four (84.2%) suggested developing a contingency plan to substitute unavailable medications with suitable alternatives, and 90 (82.6%) proposed adding more medications and devices to enhance POYC services. Analysing medication acquisition streamlines complex processes within the POYC scheme. Incorporating healthcare providers’ and patients’ insights allows a comprehensive understanding of challenges in the current scenario, enabling the identification and resolution of issues to enhance seamless care transition.