Pharmacist consultations in general practice clinics: The Pharmacists in Practice Study (PIPS) |
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| Affiliation: | 1. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, Australia;2. Pharmacy Department, Austin Health, Studley Rd., Heidelberg, VIC 3084, Australia;1. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC 3052, Australia;2. Pharmacy Department, Austin Health, Studley Rd., Heidelberg, VIC 3084, Australia;1. Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal;2. Department of Statistics and Operational Research, Faculty of Sciences, University of Lisbon, Campo Grande, 1749-016 Lisboa, Portugal;3. Faculty of Pharmacy, University of Lisbon, Research Institute for Medicines (iMed.ULisboa), Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal;1. School of Pharmacy, The University of Queensland, Pharmacy Australia Centre of Excellence, 20 Cornwall St, Woolloongabba, QLD 4102, Australia;2. School of Psychology, The University of Queensland, Room 408, McElwain Building, St. Lucia, QLD 4072, Australia;3. Pharmacy Department, Royal Brisbane and Woman''s Hospital, Butterfield St, Herston, QLD 4029, Australia |
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| Abstract: | BackgroundMedication-related problems (MRPs) are a concern in primary care settings. Pharmacists based in the community or community pharmacies are able to identify, resolve and prevent MRPs; however, the lack of a formal partnership with physicians and poor access to patients' medical records are limitations. In Australia, delivery of pharmacist services within general practice clinics is rare.ObjectivesTo evaluate the effectiveness of consultations by pharmacists based within primary care medical practices.MethodsA prospective, before-after intervention study was conducted at two primary health care (general practice) clinics in Melbourne, Australia. Participants were clinic patients who had risk-factors for MRPs (e.g. polypharmacy). Patients received a consultation with the pharmacist in a private consulting room at the clinic or in their home. The pharmacist reviewed the patient's medication regimen and adherence, with full access to their medical record, provided patient education, and produced a report for the general practitioner. The primary outcome was the number of MRPs identified by the pharmacist, and the number that remained unresolved 6 months after the pharmacist consultation. Secondary outcomes included medication adherence, health service use, and patient satisfaction.ResultsEighty-two patients were recruited and 62 (75.6%) completed the study. The median number of MRPs per patient identified by the practice pharmacist was 2 (interquartile range [IQR] 1, 4). Six months after review, this fell to 0 (IQR 0, 1), P < 0.001. The proportion of patients who were adherent to their medications improved significantly, according to both the Morisky (44.1% versus 62.7%, P = 0.023) and the Tool for Adherence Behaviour Screening (TABS) (35.6% versus 57.6%, P = 0.019) scales. There was no significant effect on health service use. Patients were highly satisfied with the pharmacist consultations.ConclusionsConsultations undertaken by pharmacists located within primary health care clinics were effective in identifying and resolving MRPs. The consultations were well received by patients and were associated with improvements in medication adherence. |
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| Keywords: | Pharmacists General practice Primary health care Medication reviews Pharmaceutical care |
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