Open Access Highly Accessed Study protocol

Pharmaceutical care for elderly patients shared between community pharmacists and general practitioners: a randomised evaluation. RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) [ISRCTN16932128]

I Wong1*, P Campion2, S Coulton3, B Cross3, H Edmondson4, A Farrin3, G Hill4, A Hilton5, Z Philips6, S Richmond2 and I Russell7

Author Affiliations

1 School of Pharmacy, University of London, Brunswick Square, London WC1N 1AX

2 Department of Public Health & Primary Care, The University of Hull, Hardy Building, Cottingham Road Hull HU6 7RX

3 Department of Health Sciences, University of York, Heslington, York YO10 5DD

4 Hull and East Riding Pharmacy Research Network, College House, Willerby Hill, Willerby HU10 6NS

5 School of Pharmacy, University of Bradford, Richmond Road, Bradford BD7 1PD

6 Department of Economics, University of Nottingham, Nottingham NG10 5DD

7 Institute of Medical and Social Care Research, University of Wales Bangor, Gwynedd LL57 2UW

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BMC Health Services Research 2004, 4:11  doi:10.1186/1472-6963-4-11

Published: 7 June 2004

Abstract

Background

This trial aims to investigate the effectiveness and cost implications of 'pharmaceutical care' provided by community pharmacists to elderly patients in the community. As the UK government has proposed that by 2004 pharmaceutical care services should extend nationwide, this provides an opportunity to evaluate the effect of pharmaceutical care for the elderly.

Design

The trial design is a randomised multiple interrupted time series. We aim to recruit 700 patients from about 20 general practices, each associated with about three community pharmacies, from each of the five Primary Care Trusts in North and East Yorkshire. We shall randomise the five resulting groups of practices, pharmacies and patients to begin pharmaceutical care in five successive phases. All five will act as controls until they receive the intervention in a random sequence. Until they receive training community pharmacists will provide their usual dispensing services and so act as controls.

The community pharmacists and general practitioners will receive training in pharmaceutical care for the elderly. Once trained, community pharmacists will meet recruited patients, either in their pharmacies (in a consultation room or dispensary to preserve confidentiality) or at home. They will identify drug-related issues/problems, and design a pharmaceutical care plan in conjunction with both the GP and the patient. They will implement, monitor, and update this plan monthly. The primary outcome measure is the 'Medication Appropriateness Index'. Secondary measures include adverse events, quality of life, and patient knowledge and compliance. We shall also investigate the cost of pharmaceutical care to the NHS, to patients and to society as a whole.