The adoption of pharmacists in general practice has resulted in improvements in prescribing quality, according to a recent study.
The research, by the University of Manchester, looked at the differences in prescribing indicators in general practices with and without pharmacists between September 2015 and December 2019. During this period, the proportion of practices employing a pharmacist increased from 3.1% to 20.5%.
The study highlighted several initiatives that were put in place to expand the clinical pharmacist workforce during this period, including the General Practice Forward View in 2016, which committed to employing 1,500 pharmacists in general practice over five years. And subsequently the Additional Roles Reimbursement Scheme which had the aim of recruiting up to six pharmacists for each PCN by 2024.
The authors noted that this time period was also chosen to avoid any influence from the Covid 19 pandemic.
It found that there were changes in a ‘broad range’ of prescribing indicators following the introduction of a clinical pharmacist in general practice. These included reduced prescribing costs and reductions in the total number of items, opioids, antibiotics and anxiolytics that were prescribed to patients.
The study authors said: ‘This supports the hypothesis that clinical pharmacist implementation results in some improvements in quality of prescribing and patient safety in primary care settings.’
However, the authors also noted the study was limited by practice-level data and that it does not account for other policy developments such as quality improvement and incentivisation to improve prescribing.
They suggested further research was needed into the broader implications of pharmacist implementation on demand for primary care services, and to what extent the changes in employment away from direct employment by general practices to employment within PCNs has impacted the improvements in prescribing.
The study concluded: ‘The current research provides evidence that supports the ongoing policy in England of expanding clinical pharmacists working within multidisciplinary teams in general practice.
‘However, further research is needed to establish the exact mechanisms by which clinical pharmacists influence quality of prescribing for different indicators.
‘For example, it is notable that clinical pharmacist implementation was associated with reductions in total antibiotic prescribing as clinical pharmacists typically do not manage acute illnesses that require antibiotics. It is possible that the presence of clinical pharmacists within general practice may influence antibiotic prescribing through other mechanisms such as antimicrobial stewardship interventions, education of GPs, or medication reviews of antibiotics on repeat prescription.’
Meanwhile, pharmacists continue to be the most popular ARRS role within PCNs, with 5,494 FTE pharmacists employed as of 31 December 2024.
A version of this article was first published by our sister title Pulse PCN
