IJPP 2003, 11: 71-80
© 2003 Int J Pharm Pract
DOI 10.1211/002235702801
ISSN 0961-7671


Faculty of Pharmacy, University of Sydney
Shalom I. Benrimoj, professor of pharmacy practice
Jane H. Langford, lecturer
Paul R. Ward, visiting research fellow

Department of Public Health, University of Sydney
Geoffrey Berry, professor of public health

Department of Pharmacy, University of Queensland
David Collins, senior lecturer

Medical Benefits Fund of Australia, Sydney
Roberta Lauchlan

Victorian College of Pharmacy, Monash University
Kay Stewart, senior lecturer

Correspondence:
Professor Benrimoj, Professor of Pharmacy Practice, Department of Pharmacy, University of Sydney NSW 2006, Australia
E-mail charlieb@pharm.usyd.edu.au

Original Papers

Clinical intervention rates in community pharmacy: A randomised trial of the effect of education and a professional allowance

Shalom I. Benrimoj, Jane H. Langford, Geoffrey Berry, David Collins, Roberta Lauchlan, Kay Stewart and Paul R. Ward

Abstract
Objectives — To quantify the rate of clinical interventions by community pharmacists, and to determine the effect of providing targeted education and/or fee-for-service professional remuneration on the rate of clinical interventions.

Methods — A randomised trial involving four groups of 10 community pharmacies: group A served as a control and received neither education nor remuneration; group B received education and professional remuneration; group C received “advanced” education and professional remuneration; and group D received professional remuneration with no education. Pharmacists in all groups documented interventions for three one-week periods. Types of intervention were pre-specified by the researchers and logged as such by the pharmacists. Interventions were categorised as “reactive” or “proactive” by a panel comprising a community pharmacist and a hospital pharmacist. Logistic regression analysis was used to compare differences in intervention rates between the groups at baseline, between groups over time (six weeks), and within groups over time.

Results — 87,130 prescription items were dispensed in the study period, and there were 762 clinical interventions, an intervention rate of 0.87%. Of the total, 375 (0.43%) were proactive and 387 (0.44%) were reactive. Groups B and C showed increases in clinical intervention rates immediately after the educational intervention, but these rates then decreased between week 1 and 2. Over the study period, group D had statistically significant reductions in intervention rates from baseline (total, reactive and proactive), and group A showed statistically significant reductions in reactive intervention rates.

Conclusions — The results from this study show that providing remuneration alone or maintaining the status quo (ie, neither remuneration nor education) did not lead to an increase in clinical interventions in community pharmacies. Increases in rates within the groups receiving education and remuneration were short lived. Developing and implementing educational programmes in addition to fee-for-service remuneration packages may have a positive impact on clinical intervention rates. Longitudinal work is required to investigate the sustainable effects of longer-term education strategies on clinical interventions in community pharmacy.