Abstract
BACKGROUND: It has been suggested that the employment of pharmacists in general practice might moderate the growth in prescribing costs. However, empirical evidence for this proposition has been lacking. We report the results of a controlled trial of pharmacist intervention in United Kingdom general practice. AIM: To determine whether intervention practices made savings relative to controls. METHOD: An evaluation of an initiative set up by Doncaster Health Authority. Eight practices agreed to take part and received intensive input from five pharmacists for one year (September 1996 to August 1997) at a cost of 163,000 Pounds. Changes in prescribing patterns were investigated by comparing these practices with eight individually matched controls for both the year of the intervention and the previous year. Prescribing data (PACTLINE) were used to assess these changes. The measures used to take account of differences in the populations of the practices included the ASTRO-PU for overall prescribing and the STAR-PU for prescribing in specific therapeutic areas. Differences between intervention and control practices were subjected to Wilcoxon matched-pairs, signed-ranks tests. RESULTS: The median (minimum to maximum) rise in prescribing costs per ASTRO-PU was 0.85 Pound (-1.95 Pounds to 2.05 Pounds) in the intervention practices compared with 2.55 Pounds (1.74 Pounds to 4.65 Pounds) in controls (P = 0.025). Had the cost growth of the intervention group been as high as that of the controls, their total prescribing expenditure would have been around 347,000 Pounds higher. CONCLUSION: This study suggests that the use of pharmacists did control prescribing expenditure sufficiently to offset their employment costs.
Full Text
The Full Text of this article is available as a PDF (44.7 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Avery A. J., Heron T. Poles apart? The views of general practitioners and family health services authority advisers on prescribing cost issues. Br J Gen Pract. 1997 Jun;47(419):347–351. [PMC free article] [PubMed] [Google Scholar]
- Harris C. M., Fry J., Jarman B., Woodman E. Prescribing--a case for prolonged treatment. J R Coll Gen Pract. 1985 Jun;35(275):284–287. [PMC free article] [PubMed] [Google Scholar]
- Lloyd D. C., Harris C. M., Roberts D. J. Specific therapeutic group age-sex related prescribing units (STAR-PUs): weightings for analysing general practices' prescribing in England. BMJ. 1995 Oct 14;311(7011):991–994. doi: 10.1136/bmj.311.7011.991. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Majeed F. A., Cook D. G., Poloniecki J., Martin D. Using data from the 1991 census. BMJ. 1995 Jun 10;310(6993):1511–1514. doi: 10.1136/bmj.310.6993.1511. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Roberts S. J., Harris C. M. Age, sex, and temporary resident originated prescribing units (ASTRO-PUs): new weightings for analysing prescribing of general practices in England. BMJ. 1993 Aug 21;307(6902):485–488. doi: 10.1136/bmj.307.6902.485. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wells W. D. Having a practice pharmacist can reduce prescribing costs. BMJ. 1998 Aug 15;317(7156):473–473. doi: 10.1136/bmj.317.7156.473. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wells W. D. Pharmacists are key members of primary health care teams. BMJ. 1997 May 17;314(7092):1486–1486. doi: 10.1136/bmj.314.7092.1486b. [DOI] [PMC free article] [PubMed] [Google Scholar]