FIP Brisbane 2023 81ST FIP WORLD CONGRESS OF PHARMACY AND PHARMACEUTICAL SCIENCES Brisbane, Australia, 24 to 28 September 2023

Pharmacist independent prescribers (IPs) reduce the risk of potential harm from polypharmacy prescriptions in care homes residents, according to a study published in the BMJ. Researchers conducted a randomised controlled trial including 72 care homes across England, Scotland and Northern Ireland. In the intervention group, care home trained pharmacist IPs were integrated into the homes to improve medicines management and safety, providing pharmaceutical care to residents, with weekly visits over six months. This included developing a pharmaceutical care plan for each resident in the trial, carrying out medicine reviews/reconciliation, training staff, supporting with medicines-related procedures, deprescribing, and authorising prescriptions. Participants in the control group received usual general practitioner led care and usual care by community pharmacists. Although fall rate risk ratio for the intervention group compared with the control group “did not show a significant reduction”, the study did show a significant reduction in Drug Burden Index. This meant that “potential future harm from medicines was significantly reduced,” the researchers say.

The International Federation of Pharmaceutical Manufacturers and Associations (IFPMA) has set out its position on substitution of biological products at community pharmacies without the consent of the prescribing health care practitioner (“pharmacy-mediated substitution”) with a biosimilar this month. It states that immunogenicity is a particular concern with all biological products and lists factors related to the potential risk of increased immunogenicity associated with switching products that should be considered. The federation also lists key recommendations for establishing a safe and efficient substitution system, including having a structured science-based framework for regulatory evaluation of pharmacy-mediated substitution in place. The position paper warns that pharmacy-mediated substitution could undermine good pharmacovigilance practices if prescribers are unaware of the setting, timing and nature of a substitution (for example in the absence of electronic health records) and so measures to ensure traceability of a biological product supplied to a patient are “particularly important” in these cases.