Non-dispensing pharmacist integrated in the primary care team: effect on the quality of physician's prescribing, a non-randomised comparative studySloeserwij, V. M., Zwart, D. L. M., Hazen, A. C. M., Poldervaart, J. M., Leendertse, A. J., de Bont, A. A., Bouvy, M. L., de Wit, N. J. & de Gier, H. J., 13-Aug-2020, In : International Journal of Clinical Pharmacy. 42, 5, p. 1293-1303 11 p.
Research output: Contribution to journal › Article › Academic › peer-review
BackgroundEspecially in elderly with polypharmacy, medication can do harm. Clinical pharmacists integrated in primary care teams might improve quality of pharmaceutical care.ObjectiveTo assess the effect of non-dispensing clinical pharmacists integrated in primary care teams on general practitioners' prescribing quality.SettingThis study was conducted in 25 primary care practices in the Netherlands.MethodsNon-randomised, controlled, multi-centre, complex intervention study with pre-post comparison. First, we identified potential prescribing quality indicators from the literature and assessed their feasibility, validity, acceptability, reliability and sensitivity to change. Also, an expert panel assessed the indicators' health impact. Next, using the final set of indicators, we measured the quality of prescribing in practices where non-dispensing pharmacists were integrated in the team (intervention group) compared to usual care (two control groups). Data were extracted anonymously from the healthcare records. Comparisons were made using mixed models correcting for potential confounders.Main outcome measureQuality of prescribing, measured with prescribing quality indicators.ResultsOf 388 eligible indicators reported in the literature we selected 8. In addition, two more indicators relevant for Dutch general practice were formulated by an expert panel. Scores on all 10 indicators improved in the intervention group after introduction of the non-dispensing pharmacist. However, when compared to control groups, prescribing quality improved solely on the indicator measuring monitoring of the renal function in patients using antihypertensive medication: relative risk of a monitored renal function in the intervention group compared to usual care: 1.03 (95% CI 1.01-1.05, p-value 0.010) and compared to usual care plus: 1.04 (1.01-1.06, p-value 0.004).ConclusionThis study did not demonstrate a consistent effect of the introduction of non-dispensing clinical pharmacists in the primary care team on the quality of physician's prescribing. This study is part of the POINT-study, which was registered at The Netherlands National Trial Register with trial registration number NTR-4389.
|Number of pages||11|
|Journal||International Journal of Clinical Pharmacy|
|Publication status||E-pub ahead of print - 13-Aug-2020|
- Non-dispensing pharmacist, Pharmaceutical care, Prescribing, Process indicator, Quality, CONTROLLED-TRIAL, INDICATORS, MEDICINE