Pharmacists implementing collaborative pharmaceutical care plans in patients with chronic disease: a prospective cohort feasibility study

Abstract Background: Pharmacists working in general practices provide medication reviews with suggestions to general practitioners to implement their recommendations to optimise medications. The next step is a model where the pharmacist takes on responsibility for implementing their recommendations. Aim: To explore the feasibility of an expanded model of collaborative pharmaceutical care in which the pharmacist has increased responsibility to manage patients with chronic diseaseMethod: This was a prospective cohort study (March to September 2018). A pharmacist developed a collaborative pharmaceutical care plan to identify drug related problems in patients with chronic disease in three general practices. The pharmacist consulted with the general practitioner discussing recommendations to manage drug related problems identified and recommendations the general practitioner was happy for the pharmacist to implement. The pharmacist implemented agreed recommendations and followed patients for six months. Outcome measures included number of recommendations implemented and drug related problems identified.Results: The pharmacist made 135 recommendations to optimise medicine use of which 126 (93.3%) were accepted by the general practitioner with 105 (83.3%) implemented by the 6-month follow up. The pharmacist was responsible for implementing 62 (49.3%) of the 126 accepted recommendations. The median number of drug related problems per patient reduced at six months compared to baseline (5 [IQR 3.3 – 7.0] vs. 2 [IQR 1.0 – 3.0]). Conclusion: The results confirm the feasibility of a pharmacist-general practitioner collaborative model within a general practice setting in Australia. The general practitioner accepted a high proportion of the pharmacist’s recommendations and almost half were implemented by the pharmacist.