Int J Pharm Pract 2002:3:39-46
Pharmacy Practice and Medicines Management Group, School of Healthcare Studies, Baines Wing, University of Leeds, Leeds, England LS2 9UT
Duncan R. Petty, BPharm, MRPharmS, research pharmacist
Arnold G. Zermansky, MB ChB, MRCGP, honorary senior research fellow and principal in general practice
David K. Raynor, PhD, MRPharmS, professor of pharmacy practice, medicines and their users
Catherine J. Lowe, PhD, MRPharmS, lecturer
Department of Primary Care and General Practice,
University of Birmingham
Nick Freemantle, MA, PhD, professor of clinical epidemiology and biostatistics
Biostatistics Group, University of Manchester
Andy Vail, BSc, MSc, lecturer
Correspondence:
Mr Petty
Original Papers
Clinical medication review by a pharmacist of elderly patients on repeat medications in general practice — pharmacist interventions and review outcomes
D. R. PETTY, A. G. ZERMANSKY, D. K. RAYNOR, C. J. LOWE, N. FREEMANTLE and A. VAIL
Objective — To describe the nature and rate of interventions made by a pharmacist conducting clinical medication reviews in general practiceMethod — Patients, randomly allocated to the intervention group, in a randomised controlled trial of 1,188 patients, were invited to a pharmacist-conducted medication review clinic at their general practice. Patients were seen over one year from June 1, 1999, to May 31, 2000. In the consultation an assessment was made of the patient, their clinical conditions and medication. Consultation outcomes for each patient and intervention outcomes for each medicine were evaluated
Setting — Patients were recruited from four randomly selected general practices in Leeds, UK. Patients were eligible if aged 65 years or over and on at least one repeat medicine
Key findings — Consultations were held with 590 patients in the intervention group (97 per cent). A recommendation for change was made in 44 per cent (258/591) of consultations. The most common outcome was a change in medication: 29 per cent of consultations (170/591). Doctor referral occurred for 28 patients (5 per cent) and nurse referral for 25 (4 per cent).
Study patients were recorded as taking 2,927 repeat medications (mode of two per patient). Interventions were made for 21 per cent of medications (603). Clinically related interventions accounted for 71 per cent (430/603). Recommendations were spread evenly across therapy groups. At the study end, 90 per cent (433/484) of recommendations remained implemented
Conclusion — A pharmacist who clinically reviewed elderly patients, their conditions and their medications, intervened in nearly half the patients. The pharmacist was able to implement most interventions without referring the patient to a doctor or nurse