A randomised controlled trial comparing two models of medication review in older patients in a community pharmacy setting

A randomised controlled trial design was chosen to compare a model of community pharmacy based clinical medication review (CMR) with no access to information from patients’ medical records (active) with a model which had access to information from patients’ medical records (control). Four hundred and eighty patients registered with 20 general practitioner (GP) practices received their allocated intervention across 16 pharmacies. There were no statistically significant differences between the groups for the two primary outcome measures used, with 1.7 and 1.9 clinical drug therapy problems (cDTPs) identified at baseline and a cDTP resolution at follow up of 61% and 57% for the active and control groups respectively. There were no significant differences between the groups in the three secondary outcome measures of GP agreement, change in number of repeat medicines and change in utilisation of healthcare services. The cost effectiveness of the two models was compared with the active group found to have a lower cost per cDTP resolved compared with the control group (£46 v £67). Thirty three patients participated in four focus groups with views expressed under the themes of change, empowerment and relationships. Fifteen pharmacists participated in two focus groups and expressed views under the themes of confidence, communication, logistics and empowerment. The hypothesis was accepted such that ‘community pharmacy based CMR of older patients (= 65 years) receiving multiple repeat medicines (= 4) identified and resolved clinical drug therapy problems irrespective of access to information from patients’ medical records’. Both models were well received by patients and practitioners.

Name dc:type.qualificationname

phd

Level dc:type.qualificationlevel

doctoral

Grantor dc:publisher.institution

University of Greenwich

Year dc:date.issued

2008

Author dc:creator

• MacLaren, Alister G.

• R Medicine (General)
• RA Public aspects of medicine
• RM Therapeutics. Pharmacology
• RS Pharmacy and materia medica