Hospitals here have started to offer a service to guide patients who are confused over medicine-taking. At least four hospitals and medical institutions now run medication review services, which help patients manage their medication effectively to prevent any medication-related problems such as overdosing or underdosing. Patients are asked to take along all the different types of medicine they are consuming, including over-the-counter medicine, medicine from private doctors, herbal supplements and vitamins, which would not be in the hospital records. This allows pharmacists to check for medication- related problems such as interactions between drugs.
Patients get a 30- to 45-minute consultation with a pharmacist, who checks that all the medicine they have brought along tally with what their hospital doctor has prescribed, said Ms Chua Lean Yen, a senior pharmacist from Tan Tock Seng Hospital. The hospital introduced a medication review service for outpatients in 2008. If there is a discrepancy between what the doctor has prescribed and what the patient is taking, the pharmacist will write to or call the doctor for advice, she said. As in a medication review done at home, the pharmacist will assess the patients’ understanding of and adherence to taking the medication prescribed. She also dispenses simple dietary advice and advice on how to cope with minor side effects of medication. Patients are usually referred by their doctor or pharmacist for a review if they are confused about the multiple types of medicine they are taking, if they are seeing three or more doctors or if there are frequent changes in their medication, said Ms Chen Li Li, a senior clinical pharmacist at Singapore General Hospital.
It was one of the earliest to start such a service for its outpatients, in 2006. Some patients or their caregivers will take the initiative to schedule a review themselves, she said. But others turn them down, claiming not to have the patience or time for it. Then there are those who believe doctors know best when it comes to medicine and pharmacists do only the dispensing. But Ms Yasmin Ng, assistant manager of Changi General Hospital’s outpatient pharmacy practice, said studies in the United States have shown that people who meet their pharmacists for medication review have better control of their health conditions. This resulted in a reduction in emergency department visits and hospitalisation and overall health-care costs. CGH introduced a medication review service for its outpatients in 2008.
Here are the hospitals and medical institutions offering the medication review service, which is sometimes known as medication therapy management:
National Cancer Centre Singapore
Medication Therapy Management Tel: 6436-8138 (for appointments)
Singapore General Hospital
Medication Management Clinic Tel: 6326-6094 (for appointments and inquiries)
Changi General Hospital
Medication Therapy Management Tel: 6850-3333 (for appointments)
Cost: $15 (first visit); $8 (follow-up visits)
Tan Tock Seng Hospital
Medication Review Service Tel: 6357-2040 (for appointments)