Inverclyde Health and Social Care Partnership, Port Glasgow Health Centre, Port Glasgow.
West Glasgow Ambulatory Care Hospital, Glasgow.
Br J Gen Pract. 2018 Oct;68(675):e735-e742. doi: 10.3399/bjgp18X699137.
General practice in the UK is experiencing a workforce crisis. However, it is unknown what impact prescribing support teams may have on freeing up GP capacity and time for clinical activities.
To release GP time by providing additional prescribing resources to support general practices between April 2016 and March 2017.
Prospective observational cohort study in 16 urban general practices that comprise Inverclyde Health and Social Care Partnership in Scotland.
GPs recorded the time they spent dealing with special requests, immediate discharges, outpatient requests, and other prescribing issues for 2 weeks prior to the study and for two equivalent periods during the study. Specialist clinical pharmacists performed these key prescribing activities to release GP time and Read coded their activities. GP and practice staff were surveyed to assess their expectations at baseline and their experiences during the final data-collection period. Prescribing support staff were also surveyed during the study period.
GP time spent on key prescribing activities significantly reduced by 51% (79 hours, <0.001) per week, equating to 4.9 hours (95% confidence interval = 3.4 to 6.4) per week per practice. The additional clinical pharmacist resource was well received and appreciated by GPs and practices. As well as freeing up GP capacity, practices and practitioners also identified improvements in patient safety, positive effects on staff morale, and reductions in stress. Prescribing support staff also indicated that the initiative had a positive impact on job satisfaction and was considered sustainable, although practice expectations and time constraints created new challenges.
Specialist clinical pharmacists are safe and effective in supporting GPs and practices with key prescribing activities in order to directly free GP capacity. However, further work is required to assess the impact of such service developments on prescribing cost-efficiency and clinical pharmacist medication review work.
英国的全科医学正面临着劳动力危机。然而,目前尚不清楚处方支持团队可能会对释放全科医生的时间和精力以用于临床活动产生何种影响。
通过在 2016 年 4 月至 2017 年 3 月期间为基层医疗提供额外的处方资源,来释放全科医生的时间。
这是一项在苏格兰因弗克莱德卫生和社会保健合作伙伴的 16 家城市基层医疗中开展的前瞻性观察队列研究。
在研究开始前的两周和研究期间的两个等效时间段内,全科医生记录了他们处理特殊请求、即时出院、门诊请求和其他处方问题所花费的时间。专科临床药师执行这些关键的处方活动,以释放全科医生的时间,并对其活动进行 Read 编码。在基线和最后一次数据收集期间,对全科医生和实践工作人员进行了调查,以评估他们的期望和经验。在研究期间还对处方支持人员进行了调查。
每周的关键处方活动时间显著减少了 51%(79 小时,<0.001),相当于每个实践每周减少 4.9 小时(95%置信区间为 3.4 至 6.4)。额外的临床药师资源受到全科医生和实践的欢迎和赞赏。除了释放全科医生的时间外,实践和从业者还发现提高了患者安全性,对员工士气产生了积极影响,并减轻了压力。处方支持人员还表示,该倡议对工作满意度产生了积极影响,被认为是可持续的,尽管实践的期望和时间限制带来了新的挑战。
专科临床药师在支持全科医生和实践进行关键处方活动方面是安全有效的,可以直接释放全科医生的时间。然而,需要进一步的工作来评估这种服务发展对处方成本效益和临床药师药物审查工作的影响。