Assessment of chronic disease status in the community pharmacy

From a therapeutic viewpoint, it would be useful if the community pharmacist had information on a patient's chronic illnesses when dispensing medicines. This study determined the concordance of pharmacists' and patients' impressions of chronic illness with those charted by general practitioners. A total of 657 patients presenting prescriptions to a health centre pharmacy were interviewed to obtain details of age, sex, prescriber and chronic illness. Details of 66 patients (who attended one GP and with self-reported chronic illness) together with their patient medication records for the previous 12 months were given to two groups of five community pharmacists, qualified for <10 years (Group I) and >25 years (Group II). Each pharmacist gave an intuitive assessment of the chronic illnesses being treated in each patient. These were compared with the GP's charted diagnoses and were placed into three categories: (i) agreement, (ii) partial agreement or (iii) non-agreement. The results (mean±sem) obtained for categories (i), (ii), (iii) respectively were: Group I 36.7±3 per cent, 43.7±5.8 per cent, 19.7±4.8 per cent and Group II 33.6±3.6 per cent, 40.6±3.8 per cent, 25.7±1.9 per cent. Patient (or their representative) assessments for (i), (ii) and (iii) were 56.1 per cent, 31.8 per cent and 12.1 per cent, respectively. The results make it clear that if there is to be a high level of concordance between pharmacy-held and GP-charted information on chronic illnesses there must be collaboration between the two professions in this regard.