A growing evidence base

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More positive results have led to a call for nationwide acceptance of pharmacists in general practice, with scope for community pharmacists to integrate in the future

A new study has added to the evidence in favour of integrating pharmacists into general practice, with benefits found for medication management in patients.

Results of a six-month study conducted in Western Sydney from October 2016 to March 2017 showed high rates of GP acceptance of pharmacist recommendations as a result of pharmacist-patient consultations across 15 general practice sites.

Six non-dispensing pharmacists involved in the project run by WentWest, also known as the Western Sydney Primary Health Network (WSPHN), identified 1124 drug-related problems across 493 patient consultations.

Pharmacists made 984 recommendations, of which 685 (70%) were recorded as accepted by the GP.

A large proportion of drug-related problems were caused by medication use without indication, and over dosage.

Other problems included untreated indication/missed therapy, lab test required, dose too low, and inappropriate drug selection.

The high rate of acceptance reveals that pharmacists have a “valuable” role to play in detecting and resolving drug-related problems as part of a general practice team, say the authors from the University of Technology Sydney and WentWest.

Their results have been published this month in the International Journal of Clinical Pharmacy.

‘We need a national approach’

PSA president Dr Shane Jackson says the results add to the broad evidence on pharmacists in general practice, highlighting that the organisation has been advocating for this “for a long period of time”.

“It’s another study in the Australian setting; it’s funded by the Primary Health Network (PHN) – some of these innovative PHNs are putting funding into pharmacists and their role in general practice,” says Dr Jackson.

2013 Australian study published in the same journal found integrated pharmacists had a similar acceptance rate of recommendations made to GPs at 71%, supporting the new findings.

And a 2016 pilot program run by the ACT’s PHN – the Capital Health Network – was so successful it was extended for another 12 months.

It received positive feedback from the GPs, patients and pharmacists involved in the program.

Despite increasing evidence, pharmacists are not currently routinely integrated into general practice in Australia, and there is no system-level funding available to support the practice.

The results show a need for a nationwide approach towards integration, says Dr Jackson.

“What this study also does is it raises the need for a national program for pharmacists in general practice,” he tells AJP.

“That’s what we put in our [Federal] Budget submission. We need a national approach to improving medications management.”

The role of community pharmacy

Co-author Professor Charlie Benrimoj, from the University of Technology Sydney, says this is just the first step in the research.

He wants to go one step further and find out whether community pharmacists can also be integrated into general practices with the same benefits.

“There’s two issues. Firstly, it’s starting to prove the effectiveness of pharmacists working with GPs and I think that’s a really good thing for patients,” Professor Benrimoj tells AJP.

“It builds evidence that pharmacists working in general practice is effective. We’ve got data from the UK that shows this as well. This is one model.

“The next step of our research is to do a randomised controlled trial.

“But after that, what we want to do is gain evidence of whether community pharmacists can integrate with GPs and can gain the same benefits. So that’s going to be the second step of research.”

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