Canadian Pharmacists Journal - May/June 2019 - 194

Original Research

KnOwLedGe IntO PrActIce
* community pharmacy-based medication assessment programs are
common in canada and abroad; however, published evaluations of
these programs are limited.
* community pharmacists in saskatchewan enjoy performing
medication assessments and are confident in their ability to provide
the service.
* community pharmacists in saskatchewan believe that the publicly
funded saskatchewan Medication Assessment Program (sMAP),
which was launched in 2013, is meeting all of the intended purposes.
* Pharmacists in saskatchewan appear to be performing sMAP
assessments, despite the many reported barriers, such as limited time,
patients having difficulty coming to the pharmacy and restrictive
program eligibility criteria.
* several recommendations to improve the sMAP have been proposed
in this article as a result of this research.

key implementation barriers and facilitators.9,10
Four additional studies used administrative
prescription drug databases to retrospectively
examine the medication assessment programs in
Ontario and British Columbia.11-14 The administrative database studies from Ontario found
that approximately 10% of eligible Ontarians
received a medication assessment in the first
6 years that their program was available,14 but
only 2.7% of the assessments for patients with
diabetes included any follow-up.13 Statistical
models were then employed to determine which
Ontarians received the service and found that
the program might not be reaching the highrisk patients who need it the most.11 The analysis
of administrative prescription drug databases
in British Columbia found that patients who
received medication assessments did not appear
to have any change in medication utilization in
the months after their assessment.12
The Saskatchewan Medication Assessment
Program (SMAP) was introduced in 2013.15 The
SMAP is a comprehensive medication assessment service, requiring all of the following tasks
to be completed: create an accurate medication
list, educate patients about their medications
and ensure regimens are appropriate, effective,
and safe. The SMAP was designed to achieve
the following purposes: ensure safe and effective medication management; improve patient
safety; prevent drug-related problems, emergency room visits and hospitalizations; reduce
medication wastage; optimize medication
194

adherence; provide support to seniors living
in the community; and assist with medication
administration.15
Pharmacies are paid a fee of $60 for an initial
assessment (which can be repeated once every
year) and $20 for each follow-up (maximum of
2 per year can be reimbursed). Saskatchewan
residents who are aged 65 years or older and are
taking 5 or more chronic medications, an anticoagulant or a medication listed in the Beers criteria are eligible to have this service reimbursed by
the provincial government.15,16 In 2016 to 2017,
the Saskatchewan government paid $776,653 in
professional fees related to the SMAP program,
yet there has been no published evaluation of the
program.15 Therefore, the aims of this study were
to determine the extent to which Saskatchewan
pharmacists believe that the SMAP is fulfilling
its intended purposes, identify the barriers and
facilitators to providing the SMAP and determine strategies pharmacists would like to see
implemented to improve the program.

Methods
Questionnaire content
This study used an online, self-administered
questionnaire. The questionnaire was developed
after reviewing the literature regarding pharmacistled medication assessment programs. A previously validated questionnaire was not identified, so one was developed for the purposes of
this study. Since one of the aims of the study
was to determine if the SMAP was achieving
the intended purposes, several questions were
developed based on the official purposes of the
program.15 Questions related to determining
the barriers and facilitators to implementing
pharmacist-led medication assessment programs were adapted from the literature.9,10,17
Key stakeholders (Pharmacy Association of Saskatchewan, Saskatchewan College of Pharmacy
Professionals, Saskatchewan Ministry of Health)
were invited to review the questionnaire and
provide suggestions. The final questionnaire was
pilot tested by 10 licensed Saskatchewan pharmacists who were not practising in a community
pharmacy setting and were therefore not eligible
to participate in the study.
The questionnaire (Appendix 1, available
online at www.cpjournal.ca) contained 53 items
with a combination of Likert scale and free-text
questions. If participants indicated that they
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Canadian Pharmacists Journal - May/June 2019

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