Clinical evaluation of community pharmacists' interventions

Abstract

Pharmacists' clinical interventions with prescriptions listed on the Australian Pharmaceutical Benefits Scheme were investigated in a pilot study set up in 30 pharmacies — 10 each from the states of New South Wales, Queensland and Victoria — stratified by city or rural location. Clinical interventions were self-reported by the 29 participating pharmacies for a period of four weeks. A total of 89,326 prescription items was dispensed in the pharmacies over the 675 recording days. There were 1,273 clinical interventions recorded from 1,053 prescription forms. Clinical interventions were divided into two main categories: reactive and proactive. The mean of the total clinical intervention rate was 1.5 per cent (SD=1.4 per cent), comprising 1.2 per cent (SD=1.2 per cent) reactive interventions and 0.3 per cent (SD=0.3 per cent) proactive interventions. A random sample of 50 proactive interventions that resulted in a change in a patient's therapy was evaluated by a clinical expert panel to determine the most likely adverse outcome avoided as a result of the pharmacist's intervention. This study provides evidence of community pharmacists' interventions with prescriptions and demonstrates that pharmacists increase the efficiency and effectiveness of patients' drug regimens and also, potentially, their welfare and quality of life.