Chronic Disease Medication Services and Comparison with the Portuguese Context

Abstract

Over the past few years, there has been a growing effort to integrate community pharmacists into managing chronic patients with chronic disease, to alleviate the pressure on healthcare systems. Pharmacists are not only experts in medicines but also have clinical skills to promote adherence to therapy and ensure monitoring of the health status of patients with chronic disease, especially in the period between medical appointments. Chronic disease medication renewal in community pharmacies is a pharmacy service that seeks to streamline patients’ access to their medication while still receiving adequate healthcare. We conducted a review of the legislation in force in different countries regarding the chronic medication renewal service and compared it with Portuguese legislation, proposing a pharmacy intervention protocol that optimizes the provision of the service. Repeat Dispensing in the United Kingdom is the service that most resembles its counterpart in Portugal: both require a 12-month medical prescription, allow access to the prescribing history (without access to clinical information). In neither of them is notification of the prescriber mandatory, both require informed consent and lead to the creation of written records of the process. Canada’s Adapt a Prescription is more comprehensive because it allows prescriptions valid for 24 months, enables access to clinical information, and requires notification of the prescriber within 24 hours. Ireland’s Prescription Extension is more limited in that it does not allow for therapeutic substitution, nor does it enable access to prescribing history or clinical information, requiring notification of the prescriber within seven days. In turn, Australia’s Continued Dispensing and the United States’ Emergency Refills differ significantly in that they do not require a long-term medical prescription, namely in situations when it is not possible to obtain a valid prescription and refusal to dispense the medicine could be life-threatening to the patient. The Chronic Medication Renewal service in Portugal arises as a response to the needs of the healthcare system and has potential in the healthcare provided to the population, specifically in the therapeutic management of patients with chronic disease.