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Pharmacist advice ignored by GPs more than half the time, finds study

Analysis of a study in which pharmacists reviewed patients’ medicines found that GPs did not implement recommended prescription changes in more than half of cases.

New research based on a study published in 2018 into patient-centred care found that over half of pharmacist recommendations for a change in prescribing were ignored by GPs, with a “high proportion” of the recommendations being described as “vague” or “indirect”.

The sub-study looked into the reasons why pharmacist recommendations in the original research had no impact on the number of drugs prescribed, and was presented by Dr Polly Duncan, GP and senior clinical research fellow at the University of Bristol, at the Society for Academic Primary Care annual conference earlier this month (July 4).

Of the 797 patients who had a pharmacist review as part of the study, 1,100 recommendations were made. The most common pharmacist recommendations were to stop or reduce a medicine (26%), switch to a medicine within the same class (18%), or review a medicine (16%).

In just 19% of cases, pharmacists did not recommend any changes to a patient's medication, yet the latest research presented by Dr Duncan found that there was “no effect on the number of drugs prescribed” in the remaining 81% of cases.

In fact, GPs ignored pharmacists' recommendations more than half the time, researchers concluded.

About the original study

The original study, conducted in 2015 by researchers at the universities of Bristol, Bath, Reading, Sydney and Laval in Canada and published in The Lancet in 2018, looked at the management of patients with multiple chronic illnesses, using a “3D approach” to primary care, where patients had their physical and mental health reviewed by a nurse and their medication reviewed by a pharmacist.

The pharmacists who took part in the study conducted a “remote medication review” on patients with three or more long-term conditions and made up to four recommendations for the GP to discuss with the patient.

Recommendations from both pharmacists and nurses were then fed back to their physician, but the approach “did not improve patients’ quality of life”, researchers concluded.

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