Controlled trial of pharmacist intervention in general practice: the effect on prescribing costs

Background. It has been suggested that the employment of pharmacists in gen eral practice might moderate the growth in prescribing costs. However, empi rical evidence for this proposition has been lacking. We report the results of a controlled trial of pharmacist intervention in United Kingdom general practice, Aim. To determine whether intervention practices made savings relative to c ontrols. Method. An evaluation of an initiative set up by Doncaster Health Authority . Eight practices agreed to fake part and received intensive input from fiv e pharmacists for one year (September 1996 to August 1997) at a cost of pou nd 163 000. Changes in prescribing patterns were investigated by comparing these practices with eight individually matched controls for both the year of the intervention and the previous year. Prescribing data (PACTLINE) were used to assess these changes. The measures used to take account of differe nces in the populations of the practices included the ASTRO-PU for overall prescribing and the STAR-PU for prescribing in specific therapeutic areas. Differences between intervention and control practices were subjected to Wi lcoxon matched-pairs, signed-ranks tests. Results. The median (minimum to maximum) rise in prescribing costs per ASTR O-PU was pound 0,85 (-pound 1.95 to pound 2.05) in the intervention practic es compared with pound 2.55 (pound 1.74 to pound 4.65) in controls (P = 0.0 25). Had the cost growth of the intervention group been as high as that of the controls, their total prescribing expenditure would have been around po und 347 000 higher. Conclusion, This study suggests that the use of pharmacists did control pre scribing expenditure sufficiently to offset their employment costs.