Good results from pharmacists in general practice: Study

Having pharmacists based in general practices can prompt good outcomes particularly for medication use, researchers have concluded.
 
In a rapid literature review published last month in the Journal of Health Services Research & Policy, UK-based researchers sifted through 3206 studies, finding 75 which met their inclusion criteria.
 
Those studies, described as ‘highly heterogeneous’ in terms of participants and methodologies, looked at the employment of pharmacists in general practices in several countries.
 
The authors state that previous literature reviews had ‘partially explored’ the effect of general practice-based pharmacists (GPBPs) across the world and described their aim as to ‘further explore the employment/integration models of GPBPs and their actual activities and impact’.
 
They said those concepts had ‘not been thoroughly investigated by previous reviews’.
 
According to the article, the impact of general practice-based pharmacists (GPBP) was assessed in the studies through observational and/or interventional research methods, and by looking at a variety of measures including contact with patients, perceptions, and patient outcomes.
 
‘Independent, quantifiable outcomes from GPBP activities were all positive but were of varying statistical significance,’ the authors wrote.
 
‘Our findings validate the usefulness of GPBP services for patients and practices, by demonstrating positive quantifiable outcomes, especially in relation to medication use.’
 
Researchers also said government funding is worth considering for large-scale and long-term integration of pharmacists.
 
‘According to the findings of this review, it is more likely for pharmacist integration into general practices to impact upon medication use rather than use of health care services [eg Accident and Emergency attendances, hospitalisations, and consultations in general practice],’ they wrote.
 
They said future research should focus on measuring quantifiable outcomes which are currently ambiguous or inconclusive evidence.
 
The researchers also suggested that studies in the future should include the follow-up of clinical indicators to establish the long-term impact of GPBP services.
 
‘Prospective studies should also attempt to quantify the precise time-savings for GPs, post-implementation of GPBP services, as well as establish any statistically significant associations between GPBP models and improvements in quantifiable outcomes,’ they wrote.
 
‘Such research would identify the most beneficial GPBP models for patients and practices.’
 
For Dr Mark Raines, a former hospital pharmacist now working as a GP in Queensland, the results of the study are interesting but he also views them as inconclusive.
 
‘Quantitative improvements have been noted in some studies, but does this translate into improved clinical outcomes, ie reduced deaths etc?’ he told newsGP.  
 
‘I think that there is a dearth of outcome studies that measure these.’
 
While he also noted a lack of consideration of publication bias in the literature review as well as limited existing data on the impact of GP pharmacists on GPs’ workload, Dr Raines believes the concept of pharmacists based in general practice is a good one.
 
‘It is certainly better than autonomous prescribing and fragmentation of care,’ he said.
 
‘I just don’t think the studies have been done which show the benefit.’
 
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