TELEPHARMACOLOGICAL OUTPATIENT CLINIC: DEVELOPMENT OF A CROSS-SECTIONAL VIRTUAL POLYPHARMACY COUNSELLING SERVICE
European Statement
Clinical Pharmacy Services
Author(s)
Lærke Karner Overgaard, Daniel Pilsgaard Henriksen
Why was it done?
Multimorbidity and polypharmacy pose significant challenges for healthcare systems. In Denmark, general practitioners (GPs) play a crucial role in coordinating patient care but also rely on specialist support for complex cases. The aim of this intervention was to provide easily accessible multidisciplinary counseling on polypharmacy for GPs.
What was done?
A virtual polypharmacy outpatient clinic was developed to provide cross-sectional specialist counseling for GPs.
How was it done?
The intervention was developed through a multidisciplinary approach, involving specialists in clinical pharmacology, GPs, and healthcare planners. The service provides virtual consultations to GPs in the Region of Southern Denmark (1.2 million inhabitants), offering multidisciplinary specialist counseling for patients on five or more medications. The multidisciplinary team consists of clinical pharmacists, consultants in clinical pharmacology and consultants in geriatrics. The process includes referral, medication review, video conference, and follow-up.
What has been achieved?
The outpatient clinic received 376 referrals comprising 366 unique patients (median age 73 years, IQR 65-81; 61.2% female) over five years (March 2019 to February 2024). The median number of drugs per patient at referral was 17 (IQR 13-21). Referrals increased from a median of 3.5 (IQR 1-5) per month in 2019-2020 to a median of 9 (IQR 6-13) per month in 2023-2024. GPs from 21 of 22 municipalities in the Region of Southern Denmark referred patients. The median time from referral to video conference was 15 days (IQR 8-26). The three most common weekdays for video conferences were: Thursday: 96 referrals (25.5%), Monday: 71 referrals (18.9%), and Wednesday: 71 referrals (18.9%)
The service was well-received by patients and GPs and recognized by national health authorities as a valuable model for managing multimorbidity. The Telepharmacological outpatient clinic thus demonstrates a successful model for integrating specialist support into primary care management of polypharmacy.
What next?
The effects of the outpatient clinic on the health outcomes of referred patients will be evaluated in a scientific study. Future efforts will focus on sharing experiences with national and international stakeholders to further develop the intervention and inspire new research in rational pharmacotherapy.