'Strong medicine': an analysis of pharmacist consultations in primary care.
BACKGROUND
Patients often find it difficult to discuss their medications fully with their prescribing doctor. Little is known about what might be said about medications to another professional within the primary health care team (PHCT). Pharmacists are seeking to extend their role within primary care and are ideally placed to provide independent medication advice.


OBJECTIVE
Our aim was to test the feasibility of using primary care pharmacists as medication counsellors, and to analyse the content of their consultations using qualitative methods.


METHODS
Some patients were referred by their doctors, some self-referred and others were invited by the pharmacists for medication reviews. Pharmacist-patient consultations took place within GP surgeries and in patients' homes, and were audiotaped, transcribed and analysed qualitatively. The study sample consisted of 25 consultations with three primary care pharmacists conducted over a 3-month period.


RESULTS
Referrals from the doctors were slow and there were no referrals from nurses. The pharmacists, who all had clinical backgrounds and were not dispensing pharmacists, experienced few problems with the consultations. Patients were willing to discuss their medications in detail with the pharmacists. A theme emerged regarding the perceived potency of medications, and this seemed to have an effect on the experience of side effects and the perceived efficacy of the medications.


CONCLUSIONS
From this small study, it would seem that pharmacist consultations within primary care are a feasible extension of their current role as prescribing budget advisors. The richness of the consultations reflects the acceptability to patients. Feedback of information to other members of the PHCT, given patient consent, would be very useful for a better understanding of the patient's perspective, which in turn would facilitate concordance in the negotiation of the patient's management.
Chen
J
J
Lewisham Primary Care Research Consortium, Rushey Green Group Practice, 410 Lewisham High Street, London SE13 6LL, UK.
Britten
N
N
D005240:Feasibility Studies; D006801:Humans; D010353:Patient Education as Topic; D010595:Pharmacists; D011320:Primary Health Care; D011369:Professional-Patient Relations; D012017:Referral and Consultation