Original ResearchPharmacist consultations in general practice clinics: The Pharmacists in Practice Study (PIPS)
Section snippets
Background
A medication-related problem (MRP) can be defined as “an event or circumstance involving medication therapy that actually or potentially interferes with an optimum outcome for a specific patient.”1 Medication-related problems are a serious concern in primary care globally.2, 3, 4, 5 They result in adverse drug events in up to 18% of general practice patients each year,5 of which nearly a quarter are preventable.2 Poor communication between health professionals has been recognized as a
Study design
A prospective, before–after intervention study was conducted at two general practice clinics in Melbourne, Australia, between December 2011 and January 2013.22 Each practice consisted of four to five full time equivalent GPs who all participated in the study. A pharmacist was employed by the research team at each clinic for at least 8 h/week, on the same day(s) each week. The pharmacists were accredited to undertake Home Medicines Reviews (HMRs) (a government subsidized program where a
Patient characteristics
A total of 82 patients were recruited (Fig. 1). Follow-up data were available for 71 patients (86.6%) at 3 months and 62 (75.6%) at 6 months. Baseline characteristics are summarized in Table 1.
Medication-related problems
Outcomes of the pharmacist consultations are summarized in Table 2. A total of 251 MRPs were identified at baseline, of which 166 MRPs related to patients who completed the study. The median (interquartile range [IQR]) number of MRPs was 2 (IQR 1, 4) in patients who completed the study, and 3 (IQR 2, 7)
Discussion
This study trialled medication consultations by a pharmacist co-located with GPs in Australian general practice clinics. The intervention identified and resolved MRPs and improved patients' medication adherence. It also provided GPs with a more accurate medication list. Patients were highly satisfied with the pharmacist consultations.
The practice pharmacist identified a median of two MRPs per patient. This aligns with the findings of other studies assessing pharmacist medication reviews
Conclusion
Pharmacist consultations in primary health care clinics in Australia identified and resolved MRPs and were associated with improved medication adherence in patients at risk of medication misadventure. Interdisciplinary practice pharmacist services were well received by patients and staff. Future research should confirm these findings in larger, controlled trials.
Acknowledgment
Funding provided by Windermere Foundation.We would like to thank the study pharmacists, Robyn Saunders and Philip Grasso, and the staff and patients of West Brunswick Clinic and Doutta Galla Community Health Service for their participation.
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