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Pharmacist management of hypertension could cut GP workload, study suggests



The majority of people starting a new antihypertensive medication could be supported by pharmacists without the need of seeing their GP again, a study of over 130,000 patients has suggested.

The research from the University of Oxford found that only 4.5% of patients who visited a pharmacist about their new treatment were referred to a GP, with many issues being dealt with directly by the pharmacist.

Researchers have said that training pharmacists for extended prescribing roles could cut GP consultations and reduce the workload for the ‘already overstretched general practice’.

The study, published in the BJGP, set out to understand what influences whether a patient is referred to a GP by a pharmacists after they start a new antihypertensive treatment.

The researchers said that while the burden of hypertension in primary care is high, and alternative models of care – such as pharmacist management – have shown promise, the data detailing the outcomes is lacking.

The team analysed 131,419 hypertension patients presenting to a community pharmacy in England with a newly prescribed antihypertensive medication, between 2011 and 2012.

They saw that a ‘total of 5,895 patients (4.5%) were referred back by a pharmacist to a GP within the first two weeks of starting a new antihypertensive medication’.

And wrote: ‘Patients reporting side effects from their new medication were the most likely to be referred to their GP in this cohort of 131,419 patients. The likely responses from clinicians to the development of such side effects could include dose reductions or switching to alternative medications.

‘Pharmacists are highly trained in the use and management of medications, and so these changes are within their professional capacity. An extended prescribing role for community pharmacists could reduce referral of routine cases to an already overstretched general practice, but would require many to undertake further training.’

This follows the announcement that a pharmacist-led review will assess the multiple medications of 180,000 care home residents, in order to to reduce overmedication and cut hospital stays.

Parents have also been told to take their child to pharmacists instead of a GP for minor ailments, as part of a campaign to cut consultations.