RT Journal Article
SR Electronic
T1 A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 17
OP 22
VO 169
IS 1
A1 Sellors, John
A1 Kaczorowski, Janusz
A1 Sellors, Connie
A1 Dolovich, Lisa
A1 Woodward, Christel
A1 Willan, Andrew
A1 Goeree, Ron
A1 Cosby, Roxanne
A1 Trim, Kristina
A1 Sebaldt, Rolf
A1 Howard, Michelle
A1 Hardcastle, Linda
A1 Poston, Jeff
YR 2003
UL http://www.cmaj.ca/content/169/1/17.abstract
AB Background: Pharmacists can improve patient outcomes in institutional and pharmacy settings, but little is known about their effectiveness as consultants to primary care physicians. We examined whether an intervention by a specially trained pharmacist could reduce the number of daily medication units taken by elderly patients, as well as costs and health care use. Methods: We conducted a randomized controlled trial in family practices in 24 sites in Ontario. We randomly allocated 48 randomly selected family physicians (69.6% participation rate) to the intervention or the control arm, along with 889 (69.5% participation rate) of their randomly selected community-dwelling, elderly patients who were taking 5 or more medications daily. In the intervention group, pharmacists conducted face-to-face medication reviews with the patients and then gave written recommendations to the physicians to resolve any drug-related problems. Process outcomes included the number of drug-related problems identified among the senior citizens in the intervention arm and the proportion of recommendations implemented by the physicians. Results: After 5 months, seniors in the intervention and control groups were taking a mean of 12.4 and 12.2 medication units per day respectively (p = 0.50). There were no statistically significant differences in health care use or costs between groups. A mean of 2.5 drug-related problems per senior was identified in the intervention arm. Physicians implemented or attempted to implement 72.3% (790/1093) of the recommendations. Interpretation: The intervention did not have a significant effect on patient outcomes. However, physicians were receptive to the recommendations to resolve drug-related problems, suggesting that collaboration between physicians and pharmacists is feasible.