|  Three papers in the latest IJPP report evaluations of aspects of new
pharmacy services provided in United Kingdom primary care.
From Scotland, general practitioners’ views of a pharmacist-led
medication review (PLMR) service were assessed. The PLMR service is offered
in Greater Glasgow by a team of specifically trained pharmacists, mainly
from community pharmacy backgrounds, who work within general practices
for one day a week. A questionnaire was sent to GPs in 82 practices where
PLMR clinics were held. There was an 84 per cent response.
Nearly all GPs thought that the service was useful. Perceived benefits
included improved prescribing practice, raised standards of patient care
and satisfaction, and increased GP knowledge and confidence. Problems
that were reported included space and time constraints, limited GP-pharmacist
contact, and occasional patient dissatisfaction. Ninety-five per cent
of GPs believed that benefits of the service outweighed problems.
The GPs had divided views on whether PLMR increased or decreased practice
workload.
Repeat dispensing project
Researchers from Aston University have evaluated one of the Department
of Health-funded repeat dispensing projects. They specifically report
now on changes in dispensing volume and costs.
Patients were provided with two successive three-monthly repeat prescriptions
containing all their “repeat” medicines, valid at a study
pharmacy. Pharmacists consulted with patients at the time of supply and
a joint agreement was reached on which medicines were needed.
Around 25 per cent of the items that patients could have received were
not dispensed during the study period. Since patients do not always ask
for all items allowed on repeat, to give a more realistic estimate of
the changes, a comparison was made with items prescribed during the six
months before the study. This showed an estimated 11.3 per cent saving
in drug costs compared with the pre-intervention period.
Pharmacists were paid on a capitation-based system, rather than fee per
item, to avoid any disincentive not to supply. This system was acceptable
to all but one of the study pharmacists.
The authors suggest that there is now a need for a large-scale study
with full cost-benefit analysis.
What do patients want?
More evidence that not all patients want the same service from their
community pharmacy comes from data collected as part of an evaluation
of patients’ perspectives on electronic transmission of prescriptions
(ETP).
Researchers from Manchester University set out to examine whether, how
and why choice and use of pharmacy services differ between patients,
and how introduction of ETP and mail order pharmacy might impact on patient
choice.
They collected data, by questionnaire and interviews, from patients participating
in the ETP pilot studies and from patients who had declined to participate.
Patients wanted a “convenient” prescription service but definitions
of convenient varied, with different patients valuing different aspects
of the service. Some, for example, welcomed the idea of not having to
go to the surgery to collect their prescription, or to the pharmacy to
collect their medicines, while others preferred — and found it
convenient — to maintain their current level of contact with GP
and pharmacist. Some liked to be able to check that their prescription
was for the correct medicine. Many infrequent users were satisfied with
the current prescription
services.
Patients who chose not to participate in ETP were less likely than participants
always to use one pharmacy.
The authors comment: “While some patients who are prescribed regular
repeat medication may welcome a greater choice of services, others may
feel that the existing choice is adequate. ... The profession needs
to ensure that the services offered cater for a variety of different
needs.”
IJPP online
The IJPP is available online via Ingenta.com. The full text is only available
to online or print/online subscribers. Print-only subscribers and non-subscribers
can purchase papers online on a “pay per view” basis. Abstracts
are available free of charge to all users. Further information is available
here.
Articles in December issue of IJPP
• Pharmacist-led medication review clinics in general practice:
the views of Greater Glasgow GPs (F. MacRae, R. Lowrie, A. MacLaren,
R. Barbour and J. Norrie)
• Use of over-the-counter medicines in children (J. McIntyre, S.
Conroy, J. Collier, N. Birchley, S. Rodgers, K. Neil, I. Choonara
and A. Avery)
• Community pharmacists’ identification of natural health
product/drug interactions in older persons (R. Grymonpre, M. McKechnie
and C. Briggs)
• Dispensing activity in a community pharmacy-based repeat dispensing
pilot project (K. Wilson and J. Jesson)
• Pharmacy services and patient choice: insights into differences
between patient groups (S. Phul, S. Cooper and J. Cantrill)
• Medically-enhanced normality: An alternative perspective on the
use of medicines for non-medical purposes (C. Møldrup, J.
Morgall Traulsen and A. Birna Almarsdóttir)
• The risk society (J. Morgall Traulsen and P. Bissell) |
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