The study evaluated a five-month program that linked family physicians with pharmacists trained to provide cognitive, clinical, patient-based care (known as “expanded role pharmacists” or ERPs) in an attempt to optimize drug therapy for seniors. The study used a “cluster randomized control trial design” that involved 889 senior patients, each using five or more medications, in 48 family practices in urban and rural Ontario. The SMART project twinned pharmacists with family physicians in the intervention group, provided access to medical records and patient interviews, facilitated recommendations on identified drug-related problems, and determined over the next five months which recommendations would be implemented. The report notes that the experiment was successful, effective, and reproducible: drug-related problems were identified in 88 per cent of the patients in the intervention group; physicians agreed to implement 84.2 per cent of the recommendations they received; and after five months, 56.5 per cent of those changes had been implemented successfully. The study found no significant differences between the intervention and control groups in terms of mean number of daily medications or medication units, proportions of appropriate or inappropriate drug use, the proportion of patients reporting a problem with their medications, or quality of life. Both physicians and pharmacists said they would recommend the method of collaboration to colleagues.
This project was supported by the Health Transition Fund, which was created in 1997 to provide support for evidence-based decision-making in health care reform by supporting pilot and evaluation projects which test innovative approaches to health care delivery. The views expressed herein do no necessarily represent the official policy of federal, provincial, or territorial governments.