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Pharmacist-led pain management 'more costly' than standard GP treatment

Pharmacist-led management of chronic pain is ‘more costly’ than when done by GPs, a study has shown.

In a randomised controlled trial, including 125 patients in three GP practices in Grampian and three in East Anglia, researchers compared GP-led ‘treatment as usual’ with pharmacist-led interventions.

Although the study indicated no worse outcomes with regards to lifespan or life quality for patients, the pharmacy-based treatment model cost £77.50 more per patient for prescribing and £54.50 more for medication review when patients were followed up after a six-month period.

The paper said: ‘Compared with [GP-led] treatment as usual, pharmacist-led interventions for chronic pain appear more costly and provide similar quality-adjusted life years’.

The review was topical amid a proposals for pharmacists to take on more of the work traditionally done by GPs, however the researchers emphasised that their pilot study was too small to draw precise conclusions and called for larger trials to take place.

It comes as last month the RCGP and the Royal Pharmaceutical Society launched a new initiative for pharmacists to work in GP practices in a role similar to practice nurses, in a move which they said would improve patient safety and care and reduce GP waiting times.

Readers' comments (13)

  • "Further detailed review of the study showed that the £23 difference was accounted for by increased use of TENS machines, homeopathic remedies and magnetic bracelets."

    :)

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  • Well there's a surprise! Instead of properly funding primary care, successive governments, PCTs CCGs try alternative modes of care - which are usually more expensive.

    It highlights what a good deal we have with primary care!

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  • usual outcomes;

    pharmacy -> go see GP
    hospital care -> go see GP
    nurse -> go see GP
    a&e -> go see GP
    OOH -> go see GP
    walk-in -> go see GP
    TV/media -> go see GP
    employer/friends/family -> go see GP
    politicians -> go see GP

    can u see where the problem might be?

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  • I'm surprised some of these headlines are even headlines. It bleeding obvious what the outcome of well trained, highly intelligent professionals treating cases they have a in depth knowledge of treating will be compared to someone who has no in-depth training about the anatomy, physiology and pathology of the human body. Its called a no brainier. do it vs all the people my colleague at 7.52 has mentioned, and there is going to be only one simple answer. NO ONE can do a GP's job properly except for a.....wait for it.....wait for it.............worth waiting for.....thats right....A GP!

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  • Pharmacists make a living selling medicines....what does anyone expect??

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  • Hmm....

    Alternatively you could present it as:

    "GP cheaper than Pharmacist".

    And by the way - "Poundland cheaper than Waitrose"

    Without knowing "why" there was a difference it's a stupid headline and a stupid article for what are supposed to be evidence-based professions to take "sides" on.

    Was the Pharmacist over-prescribing, the GP under-dosing - who knows - it doesn't say.

    Personally as a Pharmacist I never wanted to be a Doctor, I am not a trained diagnostician - period.

    What I DO know is drugs, interactions, side-effects and helping to make sure the right dose is selected in the right form to get the right compliance with the right result. Before the patient goes home and asks their neighbour whats wrong with them and how to take their medicines........

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  • Perhaps Pulse should look into how pharmacists leech NHS cash, corruptive practice and manipulation of NHS loopholes, figures and dispensed items. They are now portrayed as the saviours of 5000 years of medical care, interesting.

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  • Pharmacists do know about interactions. Usually their computer alerts them to insignificant interactions.
    They arent very good at diagnosing, a WHICH report confirmed this a few years ago. GP s have the detailed knowledge of patient co-morbidities such as renal failure, they are very capable of dosing and chosing the right medication and taking into account all other factors. The problem they have is lack of time when all the complaints of the world are laid at their door. Pharmacists could be valuable members of the primary healthcare team ,but are not an alternative to GPs.

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  • @Junior Doctor 8:58.

    Can I suggest if you have evidence as opposed to supposition then you contact the NHS Fraud Office.

    With respect there is a big difference between types of Pharmacist within the Community setting and how they are remunerated. They may be the business owner, they may be a salaried member of the GP Practice Team, they may be employed by a multi-national. Each will have differeing financial pressures to reconcile in doing the best for their patients - just the same as GPs and Doctors in secondary care do.

    One of the principal "leeches" of NHS cash is the outsourcing of Hospital OPD Dispensing to the Private Sector which allows the claiming back of the VAT - especially when the company is one like Boots which pays little or no tax in this country yet makes very substantial profits from the NHS.

    But apparently this is called "entreprenurial" not crminal and is Government Policy - go figure.......

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  • Here's a question ladies and gents. Has anyone of the above ACTUALLY READ THE ORIGINAL ARTICLE? For some insane reason, I did and it is not exactly Nobel Prize quality material (more VIZ Letterboks). It has so many potential flaws it could have been done by British Leyland in the 70s (showing my age now). Further work may be useful but this "study" aint gonna win any prizes

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