Pharmacist-supported medication review training for general practitioners: feasibility and acceptability

To investigate the feasibility and acceptability of training for general practitioners (GPs) in medication review provided by practice pharmacists.

Within the setting of a Scottish Local Health Care Co-operative incorporating 17 general practices, practice pharmacists delivered a 1-hour practice-based group training session to interested GPs, covering a systematic approach to medication review and case studies. One session of funded locum cover was provided for each GP to review up to 6 patients of his or her choice. Practice pharmacists and GPs reviewed patient notes together before GPs saw patients alone. Subsequently pharmacists abstracted data from medical records. Medication-related issues identified during reviews and resultant actions were categorised. The views of GPs on the training were obtained by postal questionnaires.

Training was received by 51/74 GPs from 10/17 practices. In 174 reviews analysed, differences in patient medication use from computer records, ineffective medication and missing computer diagnoses were identified most frequently. There was a median of 5 actions per patient, including a median of 2 changes in prescribed drugs. Only 3 reviews resulted in no actions, while 80% of patients had at least 1 prescribing record change. A total of 27 (61%) GPs returned questionnaires; most considered medication review important and were satisfied with the training. Confidence in conducting reviews increased in 14 (52%) GPs. Many indicated they would increase reviews, but time was a barrier for almost all. Although few considered contract or accreditation to be motivating factors, most agreed the training would help them achieve standards for both.

Training by pharmacists was feasible and acceptable, but time constraints may limit the translation of reviews into routine practice.