Int J Pharm Pract 1997;5:1-5

Department of Medicines Management, Keele University, Keele, Staffordshire, England ST5 5BG
Kay M. Wood, BSc, MRPharmS, research assistant (clinical pharmacy)
John C. Mucklow, MD, FRCP, senior lecturer (clinical pharmacology and therapeutics)
Elizabeth H. Boath, BA, research fellow (social science)

Correspondence: Dr Mucklow

Original Papers

Influencing prescribing in primary care: a collaboration between clinical pharmacology and clinical pharmacy

KAY M. WOOD, JOHN C. MUCKLOW and ELIZABETH H. BOATH

A study was carried out to determine whether the standard of prescribing in primary care can be improved by a therapeutics advisory service provided by a consultant clinical pharmacologist and a clinical pharmacist.
Audit, feedback, peer review, guidelines, target setting and small group teaching were used to influence behaviour in two fundholding practices: a four partner semi-rural practice in Staffordshire (practice A) and a five partner urban practice in Shropshire (practice B), both of whom paid for the therapeutics advisory service from their practice funds. The main outcome measures were changes in prescribing and disease management.
Practices A and B showed a 62 per cent and 28 per cent compliance, respectively, with recommendations for making financial savings. Blood pressure control improved in both practices, with the proportion of patients with blood pressure readings less than 160/90 mmHg rising from 47 per cent to 65 per cent in practice A, and from 53 per cent to 72 per cent in practice B, over the study period. After an intervention, the percentage of patients with non-valvular atrial fibrillation who were anticoagulated rose from 24 per cent to 57 per cent at practice B. Adherence to guidelines on the use of omeprazole by the two practices occurred in 41 per cent and 42 per cent of prescriptions, respectively, after one year, improving to 58 per cent and 56 per cent after a further year.
The approach of peer group audit, education and clinical pharmacy support was well accepted by the GPs, and early results show it may have led to an improvement in the standard of prescribing.