The potential and pitfalls of medicine management - What have we learned so far?

Community pharmacists are potentially in a strong position to contribute to improved patient care by providing medicines management services. Several major trials of community pharmacy medicines management (CPMM) have been conducted in Europe, North America, and Australia. Their findings show that some, but not all, of the potential of CPMM is being met, and thus far, evidence of benefit from CPMM is equivocal. There is a need to review the appropriateness of some of the primary outcome measures used in research to date. Key factors in pharmacy practice that impede CPMM include insufficient integration of community pharmacy input into patient pathways through treatment, poorly developed relationships between pharmacists and primary care physicians, lack of access to patient information, inadequate methods for targetting services to patients with identified medication-related problems, and community pharmacists' willingness (or lack thereof) to provide the service. Recommendations as to how to improve CPMM services so that they deliver their full potential include integrating work practices with medical colleagues, targeting of patients, providing pharmacist access to patients' medical records, and improving communication with patients.