Adoption of clinical pharmacist roles in primary care: Longitudinal evidence from English general practice

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Over the last decade, the number of clinical pharmacists working within multidisciplinary teams in English general practices has expanded.

Aim: To examine changes in quality of prescribing after the adoption of clinical pharmacists
Design and setting: Longitudinal cohort study in English general practice

Methods: Two-way fixed effects regression was used to compare differences in prescribing indicators in general practices with and without pharmacists between September 2015 and December 2019

Results: Between September 2015 and December 2019, the proportion of practices employing a clinical pharmacist increased from 236/ 7,623 (3.10%) to 1,402/ 6,836 (20.51%). Clinical pharmacist implementation resulted in statistically significant reductions in total costs of medicines per 1,000 patients (-0.85% ,95% CI -1.50%, -0.21%), the total number of opioid prescriptions per 1,000 patients (- 1.06%, 95% CI -1.82%, -0.29%), and the average daily quantity (ADQs) of anxiolytics per 1,000 patients (-1.26%, 95% CI -2.40%, -0.12%). Clinical pharmacist implementation also resulted in reductions in the total number of prescriptions per 1,000 patients (-0.58%, 95% CI -1.30%, 0.13%), and the total number of antibiotic prescriptions per 1,000 patients (-0.51%, 95% CI -1.30%, 0.27%) that trended towards statistical significance. There were no statistically significant differences in the share of broad-spectrum versus narrow-spectrum antibiotics (0.02%, 95% CI -0.07%, 0.11%) and the oral morphine equivalence of high-dose opioids (>120mg per 24 hours) per 1,000 patients (1.19%, 95% CI -0.46%, 2.85%).

Conclusion: Our analysis is limited by practice-level data but supports the hypothesis that clinical pharmacist implementation results in improvements in prescribing quality.
Original languageEnglish
JournalBritish Journal of General Practice
Early online date24 Sept 2024
DOIs
Publication statusPublished - 24 Sept 2024

Keywords

  • Clinical pharmacy
  • prescribing
  • healthcare quality
  • workforce
  • primary care

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