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Randomised controlled trial of clinical medication review by a pharmacist of elderly patients receiving repeat prescriptions in general practice

Zermansky, A.G, Petty, D.R, Raynor, D.K, Freemantle, N., Vail, A. and Lowe, C.J (2001) Randomised controlled trial of clinical medication review by a pharmacist of elderly patients receiving repeat prescriptions in general practice. BMJ, 323 (7325). pp. 1340-1343. ISSN 0959-535X

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Abstract

Objective: To determine whether a pharmacist can effectively review repeat prescriptions through consultations with elderly patients in general practice. Design: Randomised controlled trial of clinical medication review by a pharmacist against normal general practice review. Setting: Four general practices. Participants: 1188 patients aged 65 or over who were receiving at least one repeat prescription and living in the community. Intervention: Patients were invited to a consultation at which the pharmacist reviewed their medical conditions and current treatment. Main outcome measures: Number of changes to repeat prescriptions over one year, drug costs, and use of healthcare services. Results: 590 (97%) patients in the intervention group were reviewed compared with 233 (44%) in the control group. Patients seen by the pharmacist were more likely to have changes made to their repeat prescriptions (mean number of changes per patient 2.2 v 1.9; difference=0.31, 95% confidence interval 0.06 to 0.57; P=0.02). Monthly drug costs rose in both groups over the year, but the rise was less in the intervention group (mean difference £4.72 per 28 days, -£7.04 to -£2.41); equivalent to £61 per patient a year. Intervention patients had a smaller rise in the number of drugs prescribed (0.2 v 0.4; mean difference -0.2, -0.4 to -0.1). There was no evidence that review of treatment by the pharmacist affected practice consultation rates, outpatient consultations, hospital admissions, or death rate. Conclusions: A clinical pharmacist can conduct effective consultations with elderly patients in general practice to review their drugs. Such review results in significant changes in patients' drugs and saves more than the cost of the intervention without affecting the workload of general practitioners.

Item Type: Article
Copyright, Publisher and Additional Information: © 2001 BMJ Publishing Group.
Institution: The University of Leeds
Academic Units: The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Healthcare (Leeds) > Academic Pharmacy Practice (Leeds)
Depositing User: Repository Officer
Date Deposited: 28 Nov 2008 13:51
Last Modified: 08 Jun 2014 03:07
Published Version: http://dx.doi.org/10.1136/bmj.323.7325.1340
Status: Published
Publisher: BMJ Publishing
Refereed: Yes
Identification Number: 10.1136/bmj.323.7325.1340
Related URLs:
URI: http://eprints.whiterose.ac.uk/id/eprint/4911

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