Pharmaceutical needs assessment in general practice

Abstract

Abstract Objective To develop a method of prioritising the need for pharmaceutical input into a general practice. Method An adaptation of health needs assessment methodology was used to study areas of potential pharmacist input into a practice. Prescribing data, information from the practice's computer system and medical records were used to identify the practice's needs for pharmacist input and changes to practice. Interviews with practice staff and direct observation were used to obtain information on current systems and suggestions for change. A summary of the needs identified and suggestions for change were used in a prioritisation process. Setting One UK general medical practice. Key findings The study identified the need for improvements to the repeat prescribing system, a greater agreement between practice partners on the use of a practice formulary and treatment protocols, and regular review and improved monitoring of patients taking long-term medication. Among patients taking repeat medication, those aged 45 or over and those taking four or more medicines were found to be at greatest risk of having potential pharmaceutical care issues which needed to be addressed. The prioritisation process resulted in pharmacist input into maintaining registers of patients taking drugs with narrow therapeutic indexes, reviewing the practice's computer-based formulary and undertaking medication review being considered of highest priority by medical staff. Conclusion The method enabled the identification of many areas which could benefit from pharmacist input and the prioritisation of these to plan future work.