This month's learning from abroad
ARMIN: supporting better medecine management
Case study from Germany
Increasing patients' adherence to their prescribed medicines (also known as "compliance") is a key role for pharmacists. This involves determining that patients' medications are appropriate for them, safe and effective.
Pharmacists can also identify and resolve drug therapy problems that patients may be experiencing, such as difficulties with taking the prescribed formulation or unwanted side effects.
ARMIN ("Arzneimittelinitiative Sachsen-Thüringen") is a new medicines management programme aimed at patients with multiple conditions who are on multiple medications (poly-morbid/poly-pharmacy). It is being rolled out in the Sachsen and Thüringen regions of Germany.
The ARMIN programme has three modules. The first involves generic prescribing of selected active ingredients by doctors. Pharmacists then select the most appropriate product for the patient.
The second is the development of a "catalogue" or formulary of appropriate medicines for different conditions. Medicines are classified using information derived from a variety of health bodies' recommendations. The classifications are:
- "Standard" (suitable for most patients)
- "Reserve" (only for selected patients or if they have not responded to standard therapy)
- "Subordinated" (only to be used in highly specified conditions)
The catalogue of appropriate medicines has been developed for some conditions (heart diseases, osteoporosis, depression and Alzheimer's) and is to be extended further (to diabetes and antibiotics) during 2015.
The third element is the development of a medication plan or schedule for each eligible patient. This plan covers prescribed medication and supplements. The pharmacist reviews the medicines and discusses them with the patient. An initial schedule is developed by the pharmacist and this is reviewed by the prescriber, who also discusses the prescribing decisions with the patient. A final schedule is then agreed. This is continually updated with information received by the pharmacist or prescriber each time the patient receives a supply of medication.
The regular interactions that pharmacists have with their patients can be used as opportunities to improve adherence to medicines and deliver better outcomes through the development of agreed medicines management plans.
ARMIN Arzneimittelinitiative Sachsen-Thüringen