The General Practitioner–Pharmacist Collaboration (GPPC) study: a randomised controlled trial of clinical medication reviews in community pharmacy

Bryant, Linda; Coster, Gregor; Gamble, Greg; McCormick, Ross

doi:10.1111/j.2042-7174.2010.00079.x

Cited by 70 publications

(168 citation statements)

References 47 publications

(99 reference statements)

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“…Because prescribers worked external to the health authority, did not have direct interaction with the pharmacist, and did not build collaborative relationships with the pharmacist, the acceptance rate of pharmacist recommendations among prescribers was low. This rate was similar to rates seen in programs where pharmacists were not integrated into the prescriber teams 16,27,28 and was much lower than rates documented in other settings, where the pharmacist was part of the prescriberbased team. 6,29,30 If this service were to become permanent, a concentrated effort to engage prescribers from the beginning would be crucial.…”

Section: Discussionmentioning

confidence: 51%

Impact of Pharmacists in a Community-Based Home Care Service: A Pilot Program

Walus

Woloschuk

2017

CJHP

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Background: Historically, pharmacists have not been included on home care teams, despite the fact that home care patients frequently experience medication errors. Literature describing Canadian models of pharmacy practice in home care settings is limited. The optimal service delivery model and distribution of clinical activities for home care pharmacists remain unclear. Objectives: The primary objective was to describe the impact of a pharmacist based at a community home care office and providing home visits, group education, and telephone consultations. The secondary objective was to determine the utility of acute care clinical pharmacy key performance indicators (cpKPIs) in guiding home care pharmacy services, in the absence of validated cpKPIs for ambulatory care. Methods: The Winnipeg Regional Health Authority hired a pharmacist to develop and implement the pilot program from May 2015 to July 2016. A referral form, consisting of consultation criteria used in primary care practices, was developed. The pharmacist also reviewed all patient intakes and all patients waiting in acute care facilities for initiation of home care services, with the goal of addressing issues before admission to the Home Care Program. A password-protected database was built for data collection and analysis, and the data are presented in aggregate. Results: A total of 197 referrals, involving 184 patients, were received during the pilot program; of these, 62 were excluded from analysis. The majority of referrals (95 [70.4%]) were for targeted medication reviews, and 271 drug therapy problems were identified. Acceptance rates for the pharmacist's recommendations were 90.2% (74 of 82 recommendations) among home care staff and 47.0% (55 of 117 recommendations) among prescribers and patients. On average, 1.5 cpKPIs were identified for each referral. Conclusions:The pilot program demonstrated a need for enhanced access to clinical pharmacy services for home care patients, although the best model of service provision remains unclear. More research is warranted to determine the optimal pharmacy service for home care patients and the most appropriate cpKPIs to measure its effects.

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Section: Discussionmentioning

confidence: 51%

Impact of Pharmacists in a Community-Based Home Care Service: A Pilot Program

Walus

Woloschuk

2017

CJHP

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“…Although the teams were significantly effective in reducing agitated behaviour and pain of the residents, no effect was found on the level of collaboration and coordination itself [28]. In two out of three studies [293031] interventions targeting pharmaceutical care including general practitioners and pharmacists showed significant effects. In the study of Denneboom et al (2007) pharmacists suggested the changes in medication to the general practitioners after medication review.…”

Section: Resultsmentioning

confidence: 99%

“…Clinical medication reviews in collaboration with general practitioners can have a significant positive effect on the ‘Medication Appropriateness Index’. However pharmacist withdrawal from the study suggest that community pharmacy may not be an appropriate environment from which to expand clinical medication reviews in primary care [29]. Interviewing patients, development and implementation of pharmaceutical care plans together with patients’ general practitioners and monthly medication reviews with patients performed by pharmacists did not reach any significant changes in appropriateness of prescribing medication [31].…”

Section: Resultsmentioning

confidence: 99%

Outcome Indicators on Interprofessional Collaboration Interventions for Elderly

Tsakitzidis

Timmermans

Callewaert³

et al. 2016

International Journal of Integrated Care

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Background:Geriatric care increasingly needs more multidisciplinary health care services to deliver the necessary complex and continuous care. The aim of this study is to summarize indicators of effective interprofessional outcomes for this population.Method:A systematic review is performed in the Cochrane Library, Pubmed (Medline), Embase, Cinahl and Psychinfo with a search until June 2014.Results:Overall, 689 references were identified of which 29 studies met the inclusion criteria. All outcome indicators were summarized in three categories: collaboration, patient level outcome and costs. Seventeen out of 24 outcome indicators within the category of ‘collaboration’ reached significant difference in advantage of the intervention group. On ‘patient outcome level’ only 15 out of 32 outcome parameters met statistical significance. In the category of ‘costs’ only one study reached statistical significance.Discussion and conclusion:The overall effects of interprofessional interventions for elderly are positive, but based on heterogeneous outcomes. Outcome indicators of interprofessional collaboration for elderly with a significant effect can be summarized in three main categories: ‘collaboration’, patient level’ and ‘costs’. For ‘collaboration’ the outcome indicators are key elements of collaboration, involved disciplines, professional and patient satisfaction and quality of care. On ‘patient level’ the outcome indicators are pain, fall incidence, quality of life, independence for daily life activities, depression and agitated behaviour, transitions, length of stay in hospital, mortality and period of rehabilitation. ‘Costs’ of interprofessional interventions on short- and long-term for elderly need further investigation. When organizing interprofessional collaboration or interprofessional education these outcome indicators can be considered as important topics to be addressed. Overall more research is needed to gain insight in the process of interprofessional collaboration and so to learn to work interprofessionally.

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“…A randomized controlled trial in New Zealand showed community pharmacists who collaborated with general practitioners improved medication-related outcomes, but there was high pharmacist withdrawal from the trial due to business operations and perceived relationship difficulties with general practitioners. 15 In the U.S., one study described a medication therapy management service implemented in 13 community pharmacies. While provider outreach was a strong focus for year 2 of the project, there was limited discussion and detail regarding interaction with providers and how providers were part of the program's design.…”

Section: Collaboration Opportunities For Community Pharmacistsmentioning

confidence: 99%