None listed
Conditions
Brief summary
The aim of this project is to develop a doctor - pharmacist collaborative prescribing model and to consider alternative workforce models to better utilize clinical skills within the multi-disciplinary team to release medical staff time for diagnosis or more complex patients. The hypothesis of the project is that the collaborative doctor - pharmacist prescribing model provides at least as high a quality of care as usual care. Patients who have a diagnosis of HIV, have been previously medically assessed and are stable with regards to their disease will be considered for participation in the project. At their next appropriate appointment, the patient will be seen by their usual sexual health physician, given a patient information leaflet, and given the opportunity to participate in the study and provide written, informed consent. Patients will be randomised into one of two arms, to be either: -seen by their usual doctor and for their care to be managed in the usual way, or -seen by their usual doctor and the prescribing pharmacist with the aim of producing an agreed care plan, and for their subsequent appointments during the project to be managed by the prescribing pharmacist. The efficiencies of having the pharmacist responsible, under an agreed patient care plan, for all medication management aspects of the patients' appointment will be evaluated as follows. All patient consultations with the doctor or pharmacist will be audio-taped and assessed using the Medication Related Consultation Framework, for completeness of information gathered in the consultation. Patient's adherence to medications will be assessed using 3 methods, including: -pathology results (CD4 counts, viral load) -pharmacy records to establish dispensing frequency of medications -patient self-report adherence assessment tool. The completeness and legality of all prescriptions will be analysed. At the end of the study an independent, multidisciplinary panel, including doctors, pharmacists and nurses will review a random sample (50%) of patients. The panel will assess appropriateness of management and degree of concordance with the care plan. Patient satisfaction will be assessed using self-completion questionnaires. The multidisciplinary team within the clinic will be surveyed to assess their views and satisfaction on the pharmacy service before and after the project. Potential doctor time released as a result of the new model will be evaluated, as will increased access of patients to a prescriber.
Interventions
Management of previously diagnosed and stable HIV patients, under an agreed care plan between consultant sexual health physician, pharmacist and patient
Patient appointments are approximately half an hour, and scheduled routinely every 3 months. The intervention will run until all patients in the intervention arm have been seen twice by the pharmacist after the production of the initial care plan, so for approximately 6 months after care plan production for each patient.
Sponsors
Medication Services Queensland
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Previously diagnosed and stable HIV patients, as determined by their usual sexual health physician
Exclusion criteria
New patients to the clinic, without a diagnosis. Transient patients visiting the clinic from outside of the health district. Patients currently participating in clinical drug trials. Patients having prescriptions dispensed interstate Patients having pathology testing performed by private laboratories
Outcome results
None listed