Challenges in chronic illness management: a qualitative study of Australian pharmacists' perspectives

OBJECTIVE

To explore pharmacists' views on managing patients with chronic illness; to understand the incentives and barriers they perceive and the solutions they propose to overcome these barriers.

SETTING

Hospital pharmacists, with experience in managing people with chronic illnesses, working in western Sydney, Australia, were interviewed during June and July 2008.

METHOD

A qualitative study involving group and individual interviews using a semi-structured interview guide.

RESULTS

Hospital pharmacists identified lack of communication between different healthcare providers and with patients as a contributing factor to lack of continuity of care and this was perceived as a major barrier in managing patients with chronic illnesses. Pharmacists were also concerned about the effects of medication costs, and poor patient knowledge regarding their disease and medications, and the effects on adherence. Suggested solutions included taking a teamwork approach in the management of chronic illness and providing more information to patients to improve adherence.

CONCLUSION

The identified incentives and barriers have provided valuable information on what pharmacists face in managing patients with chronic illness. Most of the solutions suggested by them have been tested and proven unsuccessful. Develop successful health policy to address the identified barriers remains a challenge.

Healthcare Strategic Planning as Part of National and Regional Development in the Israeli Galilee: A Case Study of the Planning Process

This article describes a systematic process of geographic and strategic planning for healthcare services as a part of a regional development plan in the Israeli Galilee. The planning process consisted of three stages: (a) assessment of needs, demand and existing resources; (b) prioritisation of initiatives; and (c) scheduling of theoretical priorities. For many years the region has suffered from inequities and inequalities regarding the availability and accessibility of a regional healthcare system, resulting in high mortality and morbidity rates and low quality of life. The aim of the healthcare strategic plan was to suggest initiatives and actions to be taken in order to improve healthcare provision and the health and wellbeing of local residents.