Int J Pharm Pract 2002:10:185-190
Calderdale and Kirklees PCTs, West Yorkshire
Sheridan Teal, MRPharmS, pharmaceutical adviser
Lucianne Ricketts, MRPharmS, PCT pharmacist
Andrew Belton, MBChB, medical adviser
George Allsopp, prescribing information analyst
School of Pharmacy, University of Bradford, Richmond Road, Bradford, England BD7 1DP
Jonathan Silcock, MSc, MRPharmS, Boots teacher-practitioner
David J. Wright, PhD, MRPharmS, senior lecturer in pharmacy practice
Correspondence: Dr Wright
Int J Pharm Pract 2002:10:185-90
Original Papers
How effective are pharmacists who work with medical practitioners? A study of interventions intended to influence prescribing
Sheridan Teal, Lucianne Ricketts, Andrew Belton, George Allsopp, Jonathan Silcock and David J. Wright
Objective
— This study was designed to describe the interventions made by pharmacists
working within different therapeutic areas in medical practices in primary
care and to estimate the effects on prescribing.
Method — All medical practices and community pharmacists in one
health authority area in England were invited to participate. Pharmacists
were allocated to work with specific practices and training was provided
in musculoskeletal, respiratory and anxiolytic/hypnotic (sedative) prescribing.
Pharmacists negotiated and agreed with their medical practice the type
of interventions which would meet the practice's needs. Pharmacists were
remunerated to provide a maximum of eight three-hour sessions in each
medical practice on each therapeutic area over a 12-month period. Details
of all interventions were recorded by each pharmacist and countersigned
by a practice GP. A summary form was then sent to the health authority.
Analysis of prescribing data before and after intervention in all practices
was carried out using a predictive model to calculate estimated costs.
Key findings — Twenty-seven pharmacists working with 39 medical
practices participated in the study. Pharmacist interventions resulted
in 165 dose changes, 368 drug changes, 470 drug discontinuations and 1,042
patient reviews. On average, £3.99 was saved for each musculoskeletal
intervention made. This compared with an additional cost of £15.50 and
£17.92 for each intervention in sedative and respiratory prescribing,
respectively. Analysis of prescribing data showed that the total spend
in musculoskeletal and sedative prescribing in participating practices
one year after intervention was lower than that predicted.
Conclusion — Accurate recording of individual interventions with
reasons, outcomes and direct cost consequences allows purchasers to make
more informed decisions about the potential benefits of practice pharmacists.
This method may, however, underestimate the pharmacist's indirect impact
on prescribing since it does not take into account any educational effect
on prescribers.