Supporting Prescribing in Irish Primary Care: General Practice Pharmacist Study

Not Applicable

Completed

• Conditions: Multimorbidity; Polypharmacy

• Registration Number: NCT04326062
• Lead Sponsor: Royal College of Surgeons, Ireland

Brief Summary

The aim of this pilot study is to develop and test an intervention (defined as the General Practice Pharmacist \[GPP\] intervention) involving pharmacists working with General Practitioners (GPs) to optimise prescribing in Ireland. The study will determine the costs and potential effectiveness of the GPP intervention and, through engagement with key stakeholders, will explore the potential for an RCT of the GPP intervention in Irish general practice settings.

Detailed Description

Improving the quality and safety of prescribing for people with multiple chronic conditions and multiple medicines is a challenge for General Practitioners (GPs) and consequently, there has been an increased emphasis on ways to support GPs throughout this process. The integration of pharmacists into the general practice team is one approach being explored internationally and studies have shown that pharmacists, working as part of the general practice team, have influenced the safety and quality of prescribing. However, the evidence base is weak as there have been few high quality randomised controlled trials (RCTs) conducted and a range of modest effect sizes reported. Moreover, it is unclear whether such interventions can result in clinically significant improvements in patient outcomes. In Ireland, pharmacists are not integrated into general practice teams, therefore the feasibility of the integration of pharmacists into general practice warrants further exploration in the Irish primary care setting, prior to evaluation in a full scale RCT. The aim of this study is to develop and pilot test an intervention involving pharmacists, working within GP practices, to optimise prescribing in Ireland, which has a mixed public and private primary healthcare system.

Study Timeline

• Study Start: 2017-06-14
• Study First Submitted: 2018-04-26
• Status Verified: 2020-03
• Primary Completion: 2020-03-10
• Study Completion: 2020-03-10
• Study First Submitted QC: 2020-03-27
• Last Update Submitted: 2020-03-27
• Study First Posted: 2020-03-30
• Last Update Posted: 2020-03-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 100

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Changes in the number of medicines patients were prescribed.	Six months.	We recorded the number of medicines that were stopped, started or changed as a result of the pharmacist doing a medication review.
Prevalence of potentially inappropriate prescribing.	Six months.	We recorded the prevalence of potentially inappropriate prescribing identified by the pharmacist using validated indicators STOPP (Screening Tool of Older People' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). STOPP and START are validated, explicit criteria used to identify potentially inappropriate prescribing in older people (those aged 65+ years).

Secondary Outcome Measures

Name	Time	Method
Patients' self-rated health-related quality of life.	Six months.	We asked patients to rate their health-related quality of life using the European Quality of Life EQ5D-5L index score.
Self-rated attitudes of patients towards deprescribing of their medications.	Six months.	We asked patients to rate their attitudes towards deprescribing of their medications using the revised Patients' attitudes towards deprescribing (rPATD) questionnaire.
Patients' self-rated treatment burden.	Six months.	We asked patients to rate their experience of treatment burden using the Multimorbidity Treatment Burden Questionnaire (MTBQ).
Patients' self-rated health-related quality of life (VAS).	Six months.	We asked patients to rate their health-related quality of life using the Visual Analogue Scale (range 0-100)
Patients' self-rated beliefs about medicines	Six months.	We asked patients to rate their beliefs about medicines using the Beliefs about Medicines Questionnaire.

Trial Locations

Locations (1)

Royal College of Surgeons in Ireland; 🇮🇪 Dublin, Ireland