An innovative collaborative practice for clinical pharmacists in an interdisciplinary, primary care based memory clinic in Ontario, Canada

Background: It is vital that patients with cognitive impairment are diagnosed and appropriately managed early. Optimising medications is an integral part of quality care and requires expertise in geriatric pharmacotherapy. Clinical pharmacists have successfully participated in interdisciplinary care for some time, yet little attention has been given to the role pharmacists could play within a memory clinic.

Purpose: To describe the role of clinical pharmacists in a primary care, interdisciplinary memory clinic in Ontario, Canada.

Methods: Narrative description of a novel practice setting.

Results: In 2006, the Centre for Family Medicine FHT established a memory clinic. The team consisted of a family physician, social worker, and two nurses. After about 6 months of operation a pharmacist was added to the team due to the complexity of the patientÕs medication regimens, Patients are assessed over a 2 hour period by the clinic team. Pharmacists assess and rectify: 1) anticholinergic load and/or load of drugs that can impair cognition and/or function, 2) medication adherence and management skills, 3) adverse drug events, 4) vascular risk factor control; 5) provide patient education for new medication regimens and disease state education, 6) ensure seamless care by communicating with community pharmacists, and 7) conduct home visits as necessary. Pharmacotherapeutic plans are developed and implemented as appropriate, and the pharmacist is recognised as an integral part of the team.

Conclusion: The pharmacistÕs participation in this clinic has revealed an opportunity for productive collaboration, optimal use of resources, and the ability of pharmacists to manage pharmacotherapy in older patients with complex and high-risk regimens. Pharmacist participation in this clinic represents a novel opportunity to advance practice in primary care, interdisciplinary models. Additionally, certain aspects of our practice could be modified for other practice settings. Work is ongoing to further refine the role of the pharmacist in this setting.