Discussion
stock reduced wastage
SECONDARY
This secondary analysis of interview data from the process evaluation of the CHIPPS studyGPs and PIPs made clear a pharmacist independent prescriber could bring specialised clinical knowledge to the multidisciplinary team and they saw a continuing place for pharmacists in CHs. While most CH teams valued the role of the PIP, a few were still uncertain on the range of their specific responsibilities. Pharmacists have an increasingly valued place within multidisciplinary primary care teams, and this is evident within policy statements.The review of individual resident’s medicines undertaken as part of this intervention was reported by CH staff and PIPs as having readily demonstrated benefits for residents’ subjective quality of life. This understanding is important as the evidence on objective improvements in resident outcomes, that is, admission to hospital, falls or mortality from this trial and others is inconclusive.As part of the intervention service specification, PIPs spent time actively reviewing, and where appropriate, improving CH medicine systems. For example, reviewing and improving dispensing systems, consolidating MAR charts and monitoring stock control. These were reported as having benefits for CH staff in that administration and reordering were easier, and potentially safer. Improved management of stock reduced wastage and therefore had financial benefits. These findings resonate with evidence supporting the place of pharmacists within CHs.The exceptions to the positive results reported so far occurred when relational factors inhibited the scope of pharmacist contributions. For example, when the relationship between pharmacist and GP or CH could not be successfully established, or understanding of the pharmacist’s legal clinical scope was not understood. This suggests the need for strategies which will develop shared understanding of the potential of each other’s roles. Our results resonate with a survey by Kahn 