A Pharmacist Consultation Service in Community-Based Family Practices: A Randomized, Controlled Trial in Seniors
Bibliographic record
Abstract
Objective: To conduct a pilot study for a larger randomized trial investigating the efficacy and cost-effectiveness of a pharmacist consultation (PC) program for elderly patients in family practice. Design: Randomized, observer-blinded, controlled trial with two patient groups: PC and control. The study pharmacist interviewed each PC program participant in their physician's office, prepared a letter, and reviewed the drug regimen recommendations in the letter with the physician. The number and types of recommendations made, the proportion of the pharmacist's recommendations implemented by physicians, and daily medication use and costs at the end of six months are reported. Setting: One hundred thirty-two patients aged 65 years and older from four family practices in Stoney Creek, Ontario, Canada, who regularly were taking four or more medications. Results: Patient participation rates demonstrated feasibility: 191 patients were eligible, with 132 (69.1%) of these consenting to be enrolled. A mean ± SD of 3.0 ± 1.7 recommendations per patient were made for 62 (93.9%) of 66 patients in the PC group, and 77.8% (119/153) of these recommendations were implemented or partially implemented by the physicians. After six months, the mean numbers of medication units were 14.7 ± 10.8 and 13.9 ± 8.2, p = 0.66. The mean daily medication costs were $2.73 ± 1.78 and $2.47 ± 1.78, p = 0.43 in the control and PC groups, respectively. Conclusions: This pilot study demonstrated the need, the feasibility, and the potential effects of the PC program. The results were used to design a larger trial in which physicians rather than patients were randomized to further evaluate the program.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".