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

Objectives: To investigate the feasibility and acceptability of training for general practitioners (GPs) in medication review provided by practice pharmacists. Methods: 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. Results: 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. Conclusions: Training by pharmacists was feasible and acceptable, but time constraints may limit the translation of reviews into routine practice.