Evidence map›Paper›PMID 33753432›Full record

ArticleBMJ open2021

Integrating clinical pharmacists within general practice: protocol for a pilot cluster randomised controlled trial.

Aisling Croke, Frank Moriarty, Fiona Boland, Laura McCullagh, Karen Cardwell, Susan M Smith, Barbara Clyne

Abstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. 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

7 authors.

Aisling CrokeDepartment of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland aislingcroke@rcsi.com.
Frank MoriartyDepartment of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.
Fiona BolandDepartment of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.ORCID http://orcid.org/0000-0003-3228-0046
Laura McCullaghNational Centre for Pharmacoeconomics, St James's Hospital, Dublin, Ireland.
Karen CardwellDepartment of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.
Susan M SmithDepartment of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.ORCID http://orcid.org/0000-0001-6027-2727
Barbara ClyneDepartment of General Practice, Royal College of Surgeons in Ireland, Dublin, Ireland.ORCID http://orcid.org/0000-0002-1186-9495

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionManaging patients with multiple conditions (multimorbidity) is a major challenge for healthcare systems internationally, particularly in older patients. Multimorbidity and subsequent polypharmacy increase treatment burden and the risk of potentially inappropriate prescribing, and both are complex to manage in primary care. Limited evidence suggests integration of pharmacists into general practice teams could improve medication management for patients with multimorbidity and polypharmacy. Building on findings from a non-randomised, uncontrolled General Practice Pharmacist (GPP) feasibility study conducted in Irish primary care, the aim of this study is to conduct a pilot cluster randomised controlled trial (cRCT) of the GPP study, to assess feasibility, intervention impact, costs and appropriateness of continuing to a definitive cRCT. METHODS AND ANALYSIS: This pilot cRCT will involve 8 general practitioner (GP) practices and 120 patients. Practices will identify and recruit patients aged ≥65 years, who are taking ≥10 regular medications. Practices will be allocated to intervention or control after baseline data collection. Intervention practices will have a pharmacist integrated within their service, working with GPs, patients and practice staff to optimise prescribing and other medication-related activities. Control practices will provide standard GP care. The primary feasibility outcomes will include recruitment rate, uptake of medication reviews and study retention. For the primary clinical outcome, the number of potentially inappropriate prescribing incidences per patient will be collected. Secondary outcomes will include medication-related outcomes, patient-reported outcome measures, and data pertaining to the role and impact of the pharmacist on prescribing. In addition, economic and process evaluations will be conducted. ETHICS AND DISSEMINATION: This trial has been approved by the Irish College of General Practitioners Research Ethics Committee and will be performed in accordance with the Declaration of Helsinki. The results will be reported in peer-reviewed journals and be presented at national and international conferences. TRIAL REGISTRATION NUMBER: ISRCTN Registry (https://doi.org/10.1186/ISRCTN18752158).

Indexed as

General PracticePharmacistsAgedHumansInappropriate PrescribingMultimorbidityPolypharmacyRandomized Controlled Trials as Topicorganisation of health servicesprimary careprotocols & guidelines

Identifiers

PMID33753432
PMCPMC7986865

What OpenQuestion holds

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Registered trials

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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 OpenQuestion graph.