ObjectivesPharmacists and general practitioners (GPs) face an increasing expectation to collaborate interprofessionally on a number of healthcare issues, including medication non-adherence. This study aimed to propose a model of interprofessional collaboration within the context of identifying and improving medication non-adherence in primary care.SettingPrimary care; Sydney, Australia.Participants3 focus groups were conducted with pharmacists (n=23) and 3 with GPs (n=22) working in primary care.Primary and secondary outcome measuresQualitative investigation of GP and pharmacist interactions with each other, and specifically around supporting their patients’ medication adherence. Audio-recordings were transcribed verbatim and transcripts thematically analysed using a combination of manual and computer coding.Results3 themes pertaining to interprofessional collaboration were identified (1) frequency, (2) co-collaborators and (3) nature of communication which included 2 subthemes (method of communication and type of communication). While the frequency of interactions was low, the majority were conducted by telephone. Interactions, especially those conducted face-to-face, were positive. Only a few related to patient non-adherence. The findings are positioned within contemporary collaborative theory and provide an accessible introduction to models of interprofessional collaboration.ConclusionsThis work highlighted that successful collaboration to improve medication adherence was underpinned by shared paradigmatic perspectives and trust, constructed through regular, face-to-face interactions between pharmacists and GPs.
Use policyThe full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that:• a full bibliographic reference is made to the original source • a link is made to the metadata record in DRO • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders.Please consult the full DRO policy for further details. Results: Descriptive themes identified included i) dislike for medicines, ii) survival iii) perceived need, including a) symptoms and side effects and b) cost, and iv) routine. Analytic themes identified were i) identity and ii) interaction.Conclusions: This work describes adherence as a social interaction between the identity of patients and medicines, mediated by interaction with family, friends, healthcare professionals, the media and the medicine itself. Healthcare professionals and policy makers should seek to relocate adherence as a social phenomenon, directing the development of interventions to exploit patient interaction with wider society, such that patients 'get to know' their medicines, and how they can be taken, throughout the life of the patient and the prescription.
Researcher identity can present methodological and practical, as well as epistemological and ethical tensions, in sociological research. Identity management, such as the presentation of the self during a research interview, can have significant effects on the research encounter and data collected. ‘White coat syndrome’, the disjointed interaction between clinicians and patients arising from unequal power and expertise, can occur in research encounters. For clinicians engaged in social science research, identity management can be particularly challenging given the added potential for ‘white coat syndrome’. Drawing on the experiences of a registered pharmacist undertaking qualitative research, we discuss the epistemological transition many clinicians go through when embarking on sociological research. We suggest that identity management is not just a matter of optimising data collection but also has ethical tensions. Drawing on Goffman's social role theory, we discuss the epistemic tensions between researchers’ dual identities through positivist and constructivist frames, discussing the professional and legal implications, as well as the methodological practicalities of identity negotiation. We discuss conflicting professional and regulatory ethical frameworks, and ethics committees’ negotiation of intervention and elicitation during research encounters and the conflict in managing professional, legal and clinical responsibilities whilst adhering to expected social research conventions.
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