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Clinical pharmacists working in GP practices make “statistically significant” improvements in the quality of prescribing, according to a study published in the British Journal of General Practice.
As part of the study, published on 3 February 2025, researchers examined changes in the quality of prescribing after the adoption of clinical pharmacist roles in general practices in England between September 2015 and December 2019. During this period, the proportion of general practices employing a clinical pharmacist increased from 236 out of 7,623 practices (3.1%) to 1,402 out of 6,836 practices (20.5%).
The study results show that employing a clinical pharmacist resulted in “statistically significant” reductions in:
- Total costs of medicines per 1,000 patients (-0.85%, 95% confidence interval (CI) = -1.50% to -0.21%);
- Total number of opioid prescriptions per 1,000 patients (-1.06%, 95% CI = -1.82% to -0.29%);
- Average daily quantity of anxiolytics per 1,000 patients (-1.26%, 95% CI = -2.40% to -0.12%).
Employing a clinical pharmacist also resulted in reductions in the total number of prescriptions per 1,000 patients (-0.58%, 95% CI = -1.30% to 0.13%) and the total number of antibiotic prescriptions per 1,000 patients (-0.51%, 95% CI = -1.30% to 0.27%) that “trended towards statistical significance”.
However, the study found that there were no statistically significant differences in the share of broad-spectrum versus narrow-spectrum antibiotics (0.02%, 95% CI = -0.07% to 0.11%) and the oral morphine equivalence of high-dose opioids (>120 mg per 24 h) per 1,000 patients (1.19%, 95% CI = -0.46% to 2.85%).
The researchers concluded that while the analysis was “limited by practice-level data”, it “supports the hypothesis that clinical pharmacist implementation results in improvements in prescribing quality”.
This paper follows a study published in the British Journal of General Practice on 10 December 2024, which showed that the use of additional roles reimbursement scheme (ARRS) in primary care networks (PCNs) was linked to lower prescribing rates and higher patient satisfaction in GP practices.
The ARRS scheme began in England in 2019 and enables PCNs to claim salary costs for additional general practice staff to support the needs of their local population. As well as clinical pharmacists, ARRS roles include pharmacy technicians, podiatrists and dieticians.
Commenting on the latest study, Graham Stretch, president of the Primary Care Pharmacy Association, said: “These data reinforce the evidence base that adding the expertise of a pharmacist to the multidisciplinary team in general practice delivers improved outcomes.”
He added that, during the study period, the number of pharmacists in general practices in England increased owing to schemes such as the ‘Clinical pharmacists in general practice: pilot scheme’, the inception of primary care networks and the ARRS scheme.
Stretch said: “Against this background, it is pleasing to see statistically significant reductions in costs of medicines, and the total number of opioid and anxiolytic prescribing.
“These data illustrate the effectiveness of pharmacists and the returns generated on investment in expanding the team in general practice.”
Danny Bartlett, clinical lead at Kent, Surrey and Sussex Primary Care School, said: “I think this study demonstrates that prescribing something may not be the best default position and to stop and reflect on the risk/benefit of adding additional medications, particularly opioid analgesics and benzodiazepines, [which] may be more harmful than beneficial.
“With key headline benefits of increased access to medication advice for patients, increased prescribing safety and the upskilling of both new clinicians to primary care and, perhaps, some clinicians that require updating on new and changing guidelines, I see a totally different picture to the general practice that was before pharmacists were there.”
