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The results of the Community Pharmacy Medicines Management project were
presented at the British Pharmaceutical Conference and The Journal reported
its main findings (2 October, p458). A closer look at feedback from pharmacists,
GPs and patients shows that although the intervention by community pharmacists
did not lead to more appropriate treatment in patients with coronary
heart disease, those involved with the project were generally positive
about their experiences.
Fifty per cent of pharmacists said that their relationship with GPs had
improved, 97 per cent felt more knowledgeable about CHD and 88 per cent
said that they were more likely to discuss prescribed medicines with patients.
Training was rated quite highly among pharmacists, with 86 per cent believing
that it was sufficient or nearly sufficient.
Views from GPs were a little more mixed. Seventy per cent of GPs were positive
about the service; however, 31 per cent expressed concerns. During telephone
interviews opinions ranged from “Well I think it has been excellent
really ... we are looking to extend it
... it’s been very helpful” to “I don’t think
it has made a blind bit of difference”. Only 28 per cent of GPs thought
that the service would result in a decrease in their workload. In order
to deliver the service, GPs thought that pharmacists needed training, protected
time and access to records.
Patients’ experiences of the project were more consistently positive,
with 84 per cent of patients being satisfied or very satisfied with the
service. Ninety-eight per cent of patients thought that the consultation
time of 30 minutes was “about right” and more than 90 per cent
said that the consultation permitted private discussion, although this
view was challenged in the follow-up telephone interviews.
Patients in the intervention group were less likely to prefer to see their
GP than controls (76 per cent vs 85 per cent) and more likely to find it
easier to talk to their community pharmacist (32 per cent vs 18 per cent).
Christine Bond, professor of primary care, University of Aberdeen, and
a member of the evaluation team, recommended that, in the light of the
study results, the exact model of a community pharmacy-led medicines management
process should be reviewed. She said that the project worked better for
some pharmacists than for others. “We need to see why it worked better
and what went well for them, and identify those key components.”
She said that pharmacists believed that they could identify the patients
that they could have helped more (patients in the project were selected
by GPs) so pharmacists and GPs should agree locally where the need is and
use that as the focus.
She concluded by asking: “Do we need to reconsider the aims and objectives
of medicines management — do we really mean medicines management,
or is it pharmaceutical care?” |
The
Pharmaceutical Journal