Evidence map›Paper›PMID 37907299›Full record

Trial reportBMJ open2023

What happens when pharmacist independent prescribers lead on medicine management in older people's care homes: a qualitative study.

Linda Birt, Lindsay Dalgarno, Fiona Poland, David Wright, Christine Bond

Open access · goldAbstract readRandomized Controlled TrialPragmatic Clinical Trial
In one paragraph

Trial report in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Linda BirtFaculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK linda.birt@uea.ac.uk.ORCID 0000-0002-4527-4414
Lindsay DalgarnoSchool of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Fiona PolandSchool of Health Sciences, University of East Anglia, Norwich, UK.
David WrightFaculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
Christine BondSchool of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
University of East Anglia · GBUniversity of Aberdeen · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveOlder people in care homes frequently experience polypharmacy, increasing the likelihood of medicine-related burden. Pharmacists working within multidisciplinary primary care teams are ideally placed to lead on medication reviews. A randomised controlled trial placed pharmacists, with independent prescribing rights (PIPs), into older people care homes. In the intervention service, PIPs worked with general practitioners (GPs) and care home staff for 6 months, to optimise medicine management at individual resident and care home level. PIP activity included stopping medicines that were no longer needed or where potential harms outweighed benefits. This analysis of qualitative data examines health and social care stakeholders' perceptions of how the service impacted on care home medicine procedures and resident well-being.

designPragmatic research design with secondary analysis of interviews.

settingPrimary care pharmacist intervention in older people care homes in England, Scotland and Northern Ireland.

participantsRecruited from intervention arm of the trial: PIPs (n=14), GPs (n=8), care home managers (n=9) and care home staff (n=6).

resultsThere were resonances between different participant groups about potential benefits to care home residents of a medicine service provided by PIPs. There were small differences in perceptions about changes related to communication between professionals. Results are reported through three themes (1) 'It's a natural fit'-pharmacists undertaking medication review in care homes fitted within multidisciplinary care; (2) 'The resident is cared for'-there were subjective improvements in residents' well-being; (3) 'Moving from "firefighting" to effective systems'-there was evidence of changes to care home medicine procedures.

conclusionThis study suggests that pharmacist independent prescribers in primary care working within the multidisciplinary team can manage care home residents' medicines leading to subjective improvements in residents' well-being and medicine management procedures. Care home staff appreciated contact with a dedicated person in the GP practice.

trial registrationISRCTN 17847169.

Indexed as

General PractitionersPharmacistsAgedEnglandHumansNorthern IrelandQualitative ResearchSeizuresCLINICAL PHARMACOLOGYGERIATRIC MEDICINEPRIMARY CAREQUALITATIVE RESEARCHRisk management

Identifiers

PMID37907299
PMCPMC10619113
OpenAlexW4388041640

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.