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Understanding the impact of pharmacist lead medication reviews on prescribing, in primary care

A 2019/2020 Summer Studentship research project

Results of the study will give insights into whether the pharmacists' intervention is having an impact on:

  • prescribing in primary care
  • efforts to reduce the rate of inappropriate polypharmacy

Student: Rebecca Beasley
Supervisors: Dr Ben Hudson, Gareth Frew Clinical Leader Canterbury Community Pharmacy Group
Sponsor: Pegasus Health Charitable Limited

Introduction

Following the Christchurch earthquake in 2011 the Canterbury District Health Board (CDHB) faced unprecedented threats. The recovery would require pharmacists to work in new ways and out of this the Medication Management Service (MMS) was born.

MMS was part of a wider strategy to enable community pharmacists to support the consumers most at risk of medication harm. Initially the MMS funded pharmacists to visit consumers in their homes to help them understand and self-manage their medicines. The Pharmaceutical Society of New Zealand describe this activity as a Medicines Use Review (MUR).

In October 2016, following a successful pilot, the more comprehensive Medicines Therapy Assessment (MTA) service launched. The MTA service complements the existing MUR service and recognises the pharmacist's ability to provide prescribing advice, to the consumer's general practitioner (GP), to optimise the consumer's medicines.

Aim

Broadly speaking the study seeks to understand the contribution MTA makes to reducing inappropriate polypharmacy. Specifically the study will aim to:

  • understand what type of recommendations pharmacists make as part of MTA service provision
  • investigate how often recommendations to start, stop or modify doses of medications are acted on by prescribers

Method

Canterbury Community Pharmacy Group will work with Pegasus Health (Primary Health Organisation) to collate the MTA recommendations, and the medication records, for consumers who received a MTA between October 2016 and June 2018 (up to 300 consumers).

The recommendations will be categorised into recommendations for prescribers or recommendations for other members of the care team.
Following this the medication records for consumers, receiving MTA within the study period, will be reviewed to identify whether prescribers acted on the pharmacists' recommendations to start, stop or modify doses.

Student researcher’s component of the study

The student's role will be to categorise the MTA recommendations and identify common themes. Following this the student will review the medication record for each consumer to understand whether recommendations were implemented by prescribers.

Student Prerequisites

Medical or pharmacy student

How to apply

Email ben.hudson@otago.ac.nz