Evaluation of a medication safety and adherence program within a First Nations community in Saskatchewan, Canada

Abstract Background The holistic and interconnected view of health by Indigenous peoples focuses on wellness, strength and resilience. Addressing mental, physical, emotional and spiritual aspects of the individual promotes balance and harmony between all of these areas. Indigenous people face health inequities, restricted policies and social determinants of health, which put them at higher risk of developing poorer health outcomes. A number of strategies have been tested and reported in the literature, but questions remain about the optimal strategies to facilitate improved health and overall wellness for Indigenous peoples. Objective The objective of this mixed methods report is to describe a pharmacist intervention to support medication adherence of patients living with chronic health conditions in a First Nations community. Practice Description The intervention took place in a First Nations community health center. Practice Innovation A pharmacist was integrated into weekly primary care clinics to regularly monitor patients and address any medication related issues. Evaluation Methods The pharmacist intervention was evaluated qualitatively utilizing focus groups and interviews, and quantitatively by analyzing medication refill claims. Results The entire health care team believed the support provided by the pharmacist encouraged patients to take control of their health conditions, and was beneficial to increasing patient self-management behaviors including improved medication adherence. All staff appreciated the team-based model, as it optimized appointment times and promoted better patient care. Patients valued having a pharmacist they trusted and with whom they had a relationship to address their concerns. In the six months following the date of the initial visit with the pharmacist, the median number of refill claims increased in comparison to the six months prior. Conclusion A clinical pharmacist contributes to improved satisfaction and improved medication adherence when integrated into a primary care team providing care in a First Nations community.