Table 1 Summary of the outcomes collected during the General Practice Pharmacist intervention
Definition | Data Sources & Measurement | |
|---|---|---|
Main Study Outcomes (anonymised practice-level data collected throughout six-month intervention) | ||
Demographics | ||
Patient age | Age in years | Patient health record |
Gender | Male, Female, Other | Patient health record |
Patient status | Eligibility for free general practice care | Patient health record |
Primary Outcomes | ||
Patients eligible for review | Number and proportion of patients with polypharmacy presenting for repeat prescriptions per day | Patient health record Pharmacist data collection tool |
Medicines reviews | Number of reviews undertaken | Pharmacist data collection tool |
Repeat medications | Number and proportion of repeat medications currently prescribed per patient reviewed | Patient health record Pharmacist data collection tool |
Polypharmacy | Number and proportion of patients (who request a repeat prescription during the intervention period) with polypharmacy (≥10 repeat medicines) | Patient health record Pharmacist data collection tool |
Medicines stopped, started and dose alterations | Number and proportion of medicines stopped, started and altered per patient reviewed | Pharmacist data collection tool |
High risk prescribing and potentially inappropriate prescribing | Number and proportion of instances considered to be high risk or potentially inappropriate | Patient health record • High risk prescribing indicators • Modified STOPP/START criteria from OPTI-SCRIPT and SPPiRE |
Deprescribing | Number and proportion of episodes of deprescribing per patient reviewed | Pharmacist data collection tool |
Generic prescribing | Proportion of generic prescribing per practitioner | Pharmacist data collection tool |
Use of Medicines Management Programme preferred drug and prescribing and cost guidance recommendations | Number and proportion of patients with Medicines Management Programme preferred drug per item prescribed per patient reviewed | Pharmacist data collection tool |
Adverse drug reactions | Number of adverse drug reactions that caused withdrawal of prescribed medication(s) | Patient health record Pharmacist data collection tool |
Inadequate prescription instructions | Number of prescriptions with inadequate instructions (e.g. ‘as directed’) | Patient health record Pharmacist data collection tool |
Specific instances of high risk prescribing and potentially inappropriate prescribing | Number and proportion of the following instances: • Long-term use (i.e. >3 months) of non-steroidal anti‐inflammatory drug • Therapeutic duplication • Long terms use (i.e. >3 months) of corticosteroids (e.g. prednisolone) without bisphosphonate | Patient health record Pharmacist data collection tool |
Nested PROM Study Outcomes (patient-level data collected during months four and five, pseudo-anonymised until follow-up complete) | ||
Demographics | ||
Patient age | Age in years | Self-report Patient health record |
Gender | Male, Female, Other | Self-report Patient health record |
Marital status | Current marital status at time of baseline questionnaire | Self-report |
Ethnicity | Country in which patient was born | Self-report |
Education | Highest level of education achieved at time of baseline questionnaire | Self-report |
Socioeconomic status | Eligibility for free general practice care and deprivation level of electoral division wherein patient resides and their occupation | Eligibility for free general practice care will be based on self-report and confirmed by patient health record. Deprivation level of electoral division wherein patient resides classified according to Small Area Health Research Unit National Deprivation index. Occupation will be coded with Central Statistics Office occupational categories. |
Health related Quality of life [33] | Health related Quality of life five level questionnaire | Self-report |
Patients' attitudes towards deprescribing [34] | Patients’ Attitudes Towards Deprescribing questionnaire | Self-report |
Treatment burden (unpublished) | Treatment Burden Questionnaire | Self-report |
Beliefs about Medicines Questionnaire [35] | Beliefs about Medicines Questionnaire | Self-report |
Number of repeat medications | Number of repeat medications currently prescribed | Patient health record |
High risk prescribing and potentially inappropriate prescribing | Number and proportion of instances considered to be high risk or potentially inappropriate | Patient health record • High risk prescribing indicators • Modified STOPP/START criteria from OPTI-SCRIPT and SPPiRE |
Healthcare utilization | ||
GP Visits | Number of GP visits | Patient health record |
A&E visits | Number of A&E visits | Patient health record Self-report |
Hospital admissions (emergency and elective) | Number and rate of admissions Length of stay in days (if admitted) Time to first admission and time to re-admission (days) | Patient health record Self-report |
Practice nurse visits | Number of practice nurse visits | Patient health record Self-report |
Other primary care visits | Number of visits to other primary care services and identification of those services | Patient health record Self-report |
Out-patient department visits | Number of visits to out-patient department services | Patient health records Self-report |
Cost Data | ||
Healthcare utilization | As outlined in the ‘Healthcare utilisation’ section above | Patient health records Self-report |
Patient costs | Travel Occupation | Self-report |
Staff costs | Costs related to the recruitment and training of the pharmacist Practice-based education of GPs and associated staff also taken into account | Costs per hour (for GP/nurse/secretary input) and per day for pharmacist (use Health Service Executive pay grades for each grade of staff) |
Medication costs | Price for drugs supplied through the community drug schemes are listed in the reimbursement files of the Primary Care Reimbursement Service | Primary Care Reimbursement Service reimbursement files |
Process Evaluation Data | ||
Key stakeholder opinions | Stakeholder perspectives | Qualitative interview transcripts |