When Joe Walsh has a day off, it’s not uncommon to find him in the home of a patient reviewing medications and helping him or her better understand their medication therapy. Walsh is the proud owner of Walsh’s Pharmacy, a family-owned business that has been operating in the small community of Arthur for the past 60 years.
Walsh’s home visits are part of MedsCheck, a medication management program launched in 2007 by the Government of Ontario in collaboration with the Ontario Pharmacists Association and the Ontario Pharmacy Council. The service is available free of charge to anyone taking three or more prescription medications for a chronic condition, residents of licensed Long-Term Care Homes, people living with diabetes, and those who are home-bound and unable to visit their community pharmacy.
MedsCheck: At home and at the pharmacy
Walsh says that of the three MedsCheck services his pharmacy currently offers – MedsCheck at Home, MedsCheck Diabetes, and MedsCheck Annual – he enjoys visiting patients in their home the most.
“Visiting people in their homes means that I get to see people in their natural environment,” he says. This allows Walsh to see things his patients may not tell him in an office setting. For example, when arriving at the home of one gentleman, Walsh noticed that in preparation for the meeting this individual had lined up his medications on his dining room table. In the centre, there was a bottle of whiskey. This home visit provided Walsh with the opportunity to counsell the man on the dangers of consuming alcohol while taking medication.
The at-home visits also mean that Walsh can conduct a home safety inspection, allowing him to check for (and safely dispose of) expired prescriptions, and to ensure that people with mobility issues have equipped their bathrooms with safety features, such as a rubber mat on the shower floor, grab bar, transfer bench, and/or raised toilet seat. As most accidents at home occur in the bathroom, pharmacist home visits are an added benefit for people with mobility issues – Walsh says that 90 per cent of the individuals he visits do not have the above safety features.
It’s not just the at-home visits that are a success. Walsh says all MedsCheck consultations – whether at home or at the pharmacy – are benefitting patients. It’s because of MedsCheck that a patient with diabetes is now properly rotating her needle injection site. The consultations also provide Walsh with the opportunity to spend more time with patients, allowing him to more easily recognize signs of dehydration and malnourishment in other diabetics.
The MedsCheck program at Walsh’s Pharmacy is also having a positive impact on the personal and social lives of patients. Take, for instance, the gentleman who found out that he was using his inhaler incorrectly. Walsh’s intervention means that this man is now able to walk down his driveway to get his mail, something he could not do while inadvertently taking his medication in the wrong sequence.
During a MedsCheck, another female patient expressed dissatisfaction with her inactive and solitary lifestyle caused by the difficulty she was having getting up and down. Walsh recommended a rollator, a walking device equipped with a seat, and the woman is once again able to join her friends for coffee.
MedsCheck: All about the patient
As a pharmacist trained to counsell patients, Walsh says that even before the MedsCheck program came into practice six years ago he was talking to patients about their medications. The difference that the program is having is twofold: it requires pharmacists to sit down with patients for a minimum of 20 to 30 minutes to discuss their medications in detail, and it requires pharmacists to document the outcomes of the visit.
As a result, patients’ medication history is on file, making it easier for pharmacists to provide more holistic care, which includes ensuring that the most common medication-related concern – non-compliance (e.g., not taking medicine with food or at the right time of day) – is adequately addressed.
“MedsCheck is a review, a sort of tune-up for medicine,” Walsh says, adding that the primary benefit of the program is that patients are learning more about the medications they are taking, and feel better as a result. Additionally, they are staying in their homes – and out of the healthcare system – for longer.
“Patients love the MedsCheck program,” he says. “They have only positive things to say about it. Not one person has turned down the opportunity for a MedsCheck.”
But the program is not without its challenges.
“Pharmacy is not set up for appointments,” Walsh says. “One of the first things I tell my patients during a consultation is that I may be called away. There’s only one pharmacist working at one time in my pharmacy, so it can be difficult to find time for these appointments.”
In addition to the MedsCheck itself, which Walsh says can often last up to 40 or 50 minutes, time is spent preparing for and following-up on appointments.
Even so, Walsh has never been one to turn down a challenge, and he proudly announces that his record for the number of MedsCheck appointments completed in one day is eight. For Walsh, “MedsChecks are the most satisfying of my daily duties.”