%0 Journal Article
%T 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]
%A I Wong
%A P Campion
%A S Coulton
%A B Cross
%A H Edmondson
%A A Farrin
%A G Hill
%A A Hilton
%A Z Philips
%A S Richmond
%A I Russell
%J BMC Health Services Research
%D 2004
%I BioMed Central
%R 10.1186/1472-6963-4-11
%X 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.Up to 80% of elderly people may receive inappropriate therapy [1,2]. This includes over-treatment, causing adverse drug reactions [3] and under-treatment, e.g. for atrial fibrillation [4]. In the UK over-treatment is often due to the process of repeat prescribing. About 75% of all prescribed items are 'repeats' [5], that is items issued without the patient seeing the doctor. Doctors review only about 75% of these [6]. As a result elderly people are more likely to experience drug-related adverse events [7-9]. Thus they are more in need of improved prescribing than younger age groups.In England the net drug cost for elderly people (t
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