Paediatric-Pharmacy Shared Care Improves Access and Efficiency in Developmental Paediatrics.

BACKGROUND

Rising prevalence of neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), has increased demand for developmental paediatric services. Ongoing medication review requirements place increasing pressure on paediatrician-led models. Pharmacist-led shared care may improve capacity and access; however, evidence in paediatric outpatient settings remains limited.

AIM: To evaluate the impact of a paediatric-pharmacy shared-care model on wait times, service capacity and efficiency compared with medical-only care.

METHODS

We conducted a two-phase observational study. Phase 1 retrospectively analysed service activity from 2019 to 2024, including patient numbers, occasions of service, wait times, failure-to-attend rates, and financial outcomes. Phase 2 prospectively audited 100 pharmacist-led consultations to characterise clinical activities.

RESULTS

Patient numbers increased by 87%, and the proportion receiving pharmacist-led shared care rose from 4.1% to 25.3%. Pharmacy clinics had shorter wait times than medical clinics (1.84 vs. 7.64 months; p < 0.001). Following transition to shared care, median medical occasions decreased from 3 to 2 while total occasions increased from 3 to 5 (both p < 0.001). Pharmacy clinics demonstrated greater revenue efficiency (revenue-to-cost ratio 2.97 vs. 1.73). Pharmacists conducted comprehensive medication reviews including medication counselling, adherence assessment, and non-pharmacological support within a supervised framework.

CONCLUSION

The paediatric-pharmacy shared-care model was associated with shorter wait times, greater cost-efficiency, and redistribution of routine medication reviews to pharmacists, with increased overall review frequency despite fewer medical appointments per patient. Pharmacist reviews were comprehensive and delivered within a supervised framework. These findings support pharmacist-led shared care as a scalable strategy to improve access and workforce capacity in developmental paediatrics.