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Medication Adherence Practices in Community Pharmacies in Geneva, Switzerland

A Short-Term Scientific Mission experience Romania - Switzerland

Adina Turcu-Stiolica, Full Professor of Pharmaceutical Management and Marketing, Pharmacoeconomics, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, Romania

I had the opportunity to participate in a Short-term Scientific Mission (STSM) at Medication Adherence and Interprofessionality Group, at the Institute of Pharmaceutical Sciences, University of Geneva, under the supervision of Professor Marie Schneider.

Numerous methods are used by Medication Adherence and Interprofessionality Group during their research at the Institute of Pharmaceutical Sciences, University of Geneva. I was interested on the motivational interviews focused on patients’ medication behaviors combined with the use of electronic monitors containing patients’ medications (MEMS, AARDEX Group, Sion, Switzerland). When patients open the electronic monitor cap to take their medication, the date and hour at each opening were registered. I saw the electronic monitor in Pharma24, that is a living lab implementing research and teaching activities. Electronic monitors register the date and hour of each opening, which corresponds to the moment of the drug intake as long as both behaviors are consecutive. Nevertheless, one limitation of this tool is that patients could open the electronic monitor without taking the drug or swallowing it long after the electronic monitor opening. In order to limit this bias and before showing the electronic monitor data to the patient at each pharmacy visit, pharmacists check with the patients that each opening corresponds to the drug intake. They ask the patient about the usual lapse of time between each opening and the real time of the drug intake. The liquid-crystal display (LCD) screen on top of the electronic monitor cap resets at 3 AM each morning. Hence, each time the patient opens the electronic monitor cap, the LCD shows the number of cumulative openings until 3 AM on the next day. The LCD screen reminds the patient about whether the medication has been taken or not.

In Romania, the Ministry of Health Order (Ord.MoH. no. 2382/2021) delineates the advanced service for monitoring chronic patients with different chronic diseases, as, for example, diabetes SFA02-2 as follows: „The chronic patient management service involves the assessment of medication and vital functions/biological parameters, where necessary, verification of treatment adherence, as well as the evaluation of patients without pharmacological treatment through counseling (guiding the patient towards a medical consultation, hygienic-dietary regimen, etc.) and monitoring.” The experience I have gained with Professor Marie Schneider at introducing MyCare Start-I project „Implementation of a new model of care for supporting adherence in people starting a new medication for a long-term condition” let me to propose a project which aims to develop an intervention of pharmacists in community pharmacy in Romania that will support medication adherence to antidiabetic medication as a SFA02-2 pharmaceutical service. A cost-effectiveness evaluation of the intervention will be performed. This will be a multicentric, national implementation science project conducted in collaboration with two university partners and across 100-150 community pharmacies in Romania.

I look forward to meeting again Professor Marie Schneider and presenting the results of my projects in Romania.