ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Drugs Outcomes Research and Policies
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1690480
This article is part of the Research TopicPharmacist and patient safety: Focus on drug safetyView all 4 articles
Clinical Pharmacist Prescriber in Primary Care in Slovenia: Prospective Non-Randomised Interventional Study Focused on Clinical Outcomes and Quality of Life
Provisionally accepted
Matej Stuhec1*
Alenka Kovacic1,2
Marjetka Korpar1,3Ana Banovic Koscak4Barbara Koder5Dunja Mahoric6Spela Bernik7Eva Gorup Cedilnik8Vesna Homar8
Aleksander Stepanović8Danica Rotar Pavlic8- 1Faculty of Medicine, University of Maribor, Maribor, Slovenia
- 2Splosna bolnisnica Murska Sobota, Murska Sobota, Slovenia
- 3Lekarna Ptuj, Ptuj, Slovenia
- 4Goriška lekarna Nova Gorica, Rejčeva ulica 2, 5000 Nova Gorica, Slovenia, Nova Gorica, Slovenia
- 5Gorenjske Lekarne, Kranj, Slovenia
- 6Lekarna Toplek, Ptuj, Slovenia
- 7Lekarniska zbornica slovenije, Ljubljana, Slovenia
- 8Univerza v Ljubljani Medicinska fakulteta, Ljubljana, Slovenia
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Introduction: Clinical pharmacist prescribers in primary care settings and their impact on patient-reported outcome measures (PROMs) and clinical outcomes have not been described outside English-speaking countries. Aim: The aim of this prospective interventional pilot study was to assess the impact of pharmacist prescribers on clinical results and PROMs, while describing their development, evaluation, and implementation in Slovenia. Methods: This prospective, six-month, interventional, non-randomised study started in November 2024 and concluded in June 2025 in four primary care settings in Slovenia. Clinical pharmacists reviewed medications of patients and additionally prescribed medications based on the Collaborative Practice Agreement (CPA). In this process, they cooperated with patients and general practitioners (GPs). Only patients with an established diagnosis for selected noncommunicable chronic conditions were included. The primary outcomes were changes in PROMs, including quality of life (assessed via EQ-5D-VAS), and the Medication Appropriateness Index (MAI). Secondary outcomes included the prescription acceptance rate by GPs (percentage) and adherence to treatment guidelines. Tertiary outcomes involved the number of prescriptions that met the predefined clinical outcomes. Results: The study included 119 patients, with a mean age of 72.3 years (SD = 10.0). Quality of life improved from 63.6/100 (SD = 18.7) at baseline to 71.4/100 (SD = 15.9) at the end of the study (p = 0.000), with a corresponding QALY difference of 0.0252. The effect size (Cohen's d) was 0.448 (95% CI: 0.084 to 0.812. The number needed to treat (NNT) was 4.0. During the study, clinical pharmacists prescribed 264 prescriptions to 119 patients, resulting in an acceptance rate of 91.3%. Adherence to treatment guidelines improved significantly (29.8% vs. 90.9%; p = 0.000). The effect size, expressed as an odds ratio (OR), was 25.7 (95% CI: 15.6 to 42.4). The number of prescriptions achieving the predefined clinical outcomes was significantly higher at the end of the study (70.8% vs. 6.4%; p = 0.000), with an OR of 33.9 (95% CI: 19.1 to 60.4). Deprescribing accounted for 25.3% of all protocols.Conclusions: This study demonstrates that prescriptions made by clinical pharmacists in collaboration with GPs, as specified in the CPA, improved PROMs and clinical outcomes for predefined conditions.
Keywords: Pharmacist prescriber, Clinical Pharmacy, family medicine, medicationreview, Primary Care
Received: 21 Aug 2025; Accepted: 01 Sep 2025.
Copyright: © 2025 Stuhec, Kovacic, Korpar, Banovic Koscak, Koder, Mahoric, Bernik, Gorup Cedilnik, Homar, Stepanović and Rotar Pavlic. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Matej Stuhec, Faculty of Medicine, University of Maribor, Maribor, Slovenia
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