Process evaluation for the Care Homes Independent Pharmacist Prescriber Study (CHIPPS)

Area of Science:

• Gerontology
• Health Services Research
• Pharmacy Practice

Background:

• Medicines management in care homes presents significant challenges.
• The CHIPPS trial evaluated integrating pharmacist independent prescribers (PIPs) into care homes.
• This study reports on the parallel mixed-methods process evaluation of the CHIPPS intervention.

Purpose of the Study:

• To determine the effectiveness of integrating PIPs into care homes for medicines management.
• To evaluate the implementation process and stakeholder perceptions of the intervention.
• To identify facilitators and barriers to the successful integration of PIPs in care homes.

Main Methods:

• A cluster randomised controlled trial involving 25 triads (care homes, GPs, PIPs).
• Data collected via pharmaceutical care plans, pharmacist activity logs, online questionnaires, and semi-structured interviews.
• Quantitative data analysed descriptively; qualitative data analysed thematically.

Main Results:

• All stakeholders reported benefits and no safety concerns with PIPs managing medicines.
• PIPs reported increased knowledge and valued engagement time; 566 clinical interventions were recorded, with significant deprescribing.
• Medication changes reduced falls risk for a quarter of residents; implementation was most effective with established communication pathways.

Conclusions:

• The integration of PIPs into care homes was generally implemented as intended and well-received.
• Contextual factors influenced PIP engagement, highlighting the importance of established communication.
• The intervention demonstrated potential for improving medication safety and resident quality of life in care homes.