Meds reviews impact limited, study finds

pharmacist with patient explaining medicines

A new Canadian study has found that medication reviews conducted by pharmacists did not significantly modify prescription drug use

But comparing this to the Australian model is like “comparing an egg with a soufflé,” one Twitter commentator pointed out.

The study, which collected data on community pharmacist-led medication reviews via British Columbia’s population-based PharmaNet drug utilisation system, sparked debate on Twitter including from Dr Evan Ackermann, who has been vocal about community pharmacy on the platform.

Researchers studied the impact of first medication reviews conducted between May 2012 and June 2013, using interrupted time series analysis to assess longitudinal changes in 147,770 patients receiving a standard review and a more intensive pharmacist consultation (16,006 patients).

“Our outcomes included drug utilisation, costs, potentially inappropriate prescriptions, and medication persistence measured through the proportion of commonly used chronic medications that were eventually refilled,” the authors wrote.

“Overall, we observed few changes in the level or trend of any of the outcomes we studied. Both review types were followed by significant increases in both the number of prescriptions per month and expenditures.

“The continuation of long-term medications did not change for three of four classes, and increased very slightly for the final class. We found no evidence of deprescribing, either for classes that are potentially problematic for long-term use (benzodiazepines and proton pump inhibitors) or for potentially inappropriate prescriptions in seniors.

“Our results suggest that medication reviews did not significantly modify prescription drug use by recipients.

“Future iterations of such programs might be modified to be better targeted and to encourage closer collaboration between pharmacists and prescribing health care professionals.”

Rural GP and Deputy Chairman of the RACGP National Quality Committee Dr Evan Ackermann highlighted the study’s findings…

…but CR&C (Campbell Research) was quick to ask how these interventions compared to Australian practice.

Dr Ackermann admitted that being pharmacist-only, the findings were “less comparable”.

Meanwhile, Rohan Elliott said that given the nature of the interventions, their limited impact was not surprising.

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