Collaboration between pharmacists and general practitioners (GPs) has been shown to enhance patient care and outcomes. The aim of the present study was to investigate the collaborative working relationship between pharmacists and GPs in terms of their attitudes, role perceptions, experience with collaborative practice, preferred method of communication, areas of current and further collaboration, and perceived barriers to interprofessional collaboration in a sample of the Iranian population. We distributed 318 questionnaires to community pharmacists and GPs in Tehran. Both groups had a positive attitude towards collaboration; however, about half the respondents reported only occasional collaborative practice. Both groups preferred communication by telephone or face-toface communication by fax or letter. Few current areas of collaboration were identified; however, an area favoured by both groups was "decision-making for patients' pharmacotherapy". The two groups expressed concern about possible fragmentation of patient care with the involvement of multiple health care providers, and perceived lack of face-to-face communication as a possible barrier to collaboration. Les deux groupes étaient favorables à la collaboration, mais près de la moitié des participants ont rapporté n'entretenir des relations de collaboration que sur une base occasionnelle. Les deux groupes ont déclaré préférer une communication par téléphone ou en face à face que par fax ou courrier. Peu de domaines faisant l'objet d'une collaboration actuelle ont été identifiés. Cependant, les deux groupes avaient pour domaine de prédilection « la prise de décision concernant la pharmacothérapie des patients ». Les deux groupes se sont dit préoccupés par une possible fragmentation des soins dispensés aux patients du fait de l'apparition de multiples prestataires de soins de santé, et percevaient le manque de communication en face à face comme une barrière potentielle à la collaboration. اإلسالمية
Purpose: We described the rationale, structure, design, and components of a provincial pharmacy services network for patients with kidney disease as a model for enabling equitable access and universal care to pharmacy services and medications across a wide range of clinical conditions, and geographic expanse in British Columbia (BC). Sources of Information: These include minutes from 53 Pharmacy Services and Formulary (PS&F) Committee meetings held from 1999 to November 2022, documentation available on the British Columbia Renal (BCR) website, direct observation and participation in committee meetings, as well as interviews with key individuals involved in different aspects of the program. Methods: We reviewed documents and data describing the evolution, rationale, and functioning of the BCR provincial pharmacy services system and used a variety of sources as mentioned above. In addition, a qualitative thematic synthesis of reports of chronic care models (CCMs) was conducted to map the program components into the chronic disease management models. Key Findings: The components of the provincial pharmacy program (PPP) include (1) a PS&F committee, with interdisciplinary and geographical representation; (2) a community of dispensing pharmacies with standardized protocols and information; (3) a dedicated medication and pharmacy services budget, and regular evaluation of budget, outcomes, and performance; (4) provincial contracts for specific medications; (5) communication and education; and (6) information management system. Program components are described in the context of chronic disease management models. The PPP includes dedicated formularies for people with kidney disease at different points in the disease trajectory, including those on and off dialysis. Equitable access to medications is supported across the province. All medications and counseling services are provided to all patients registered in the program, through a robust distributed model, including community- and hospital-based pharmacies. Provincial contracts managed centrally ensure best economic value, and centralized education and accountability structures ensure sustainability. Limitations: Limitations of the current report include lack of formal evaluation of the program on patient outcomes, but this is relative as the intention of this article is to describe the program which has existed for over 20 years and is fully functional. Formal evaluation of a complex system would include by costs, cost avoidance, provider, and patients’ satisfaction. We are developing a formal plan for this reason. Implications: The PPP is embedded in the provincial infrastructure of BCR and enables the provision of essential medications and pharmacy services for patients with kidney disease throughout the spectrum. The leveraging of local and provincial resources, knowledge, and expertise to implement a comprehensive PPP, ensures transparency and accountability and may serve as a model for other jurisdictions.
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