Pharmacist-led Medicines Management Outpatient Service

It widely accepted that a number of medication related problems can occur after the patient has been discharged from the hospital. An obvious extension of the ongoing integrated medicines management programme (IMMP) is therefore to provide a medicines management clinic within an outpatient setting as well as follow-up telephone calls from a clinical pharmacist. This study aims to assess the influence a pharmacist-led medicines management outpatient service on patients at high risk of medication related problems. It is anticipated that this service will * Ensure continuity of pharmaceutical care for patients post discharge. * Reinforce patient education in order to improve knowledge and understanding of the medication prescribed. * Ensure that both prescription medicines and OTC preparations are used appropriately. * Facilitate the communication with other members of healthcare team in order to agree and implement measures to overcome medication related problems.