ABSTRACT

The objective of the study is to design, implement and evaluate a patient monitoring process by involving community pharmacists in order to maintain continuity of care in patients with rheumatoid arthritis. The study was undertaken in Glasgow between December 2001- November 2002, as a shortterm randomised controlled trial. Community pharmacists were randomly assigned to the study and the control group. The study group were intended to receive a methotrexate care plan issued by the rheumatology specialists and by the pharmacist at the hospital which is designed to enable the pharmacist to support the general practitioner in the patient monitoring role. The control group patients only received a methotrexate monitoring card in addition to their routine health care that they used to receive. During the recruitment period, 30 community pharmacists (17 in the control; 13 in the study group) and 59 patients (31 in the control; 28 in the study group) were involved. For the total patient population, 76% were female, 85% were diagnosed with rheumatoid arthritis, 13.3% with psoriatic arthritis and 1.7% with polyarthritis. The comparison between the frequency of the identified drug therapy problems in the hospital and in the community settings showed no statistically significant difference regarding the medication needs and safety problems (Chi-square test, p>0.05). There were significantly more drug therapy problems identified in the hospital clinics for the effectiveness and compliance problems (Chi-square test, p<0.05). In conclusion, pharmacists are in a distinct position to support patient care through identifying drug therapy problems, guidance on patient self-management and monitoring of the patients who potentially need extra vigilance in the community settings.