A qualitative study on pharmacists’ perception on integrating pharmacists into private general practitioner’s clinics in Malaysia

Abstract

Background:Private general practitioners in Malaysia largely operates as solo practices – prescribing and supplying medications to patients directly from their clinics, thus posing risk of medication-related problems to consumers. A pharmacy practice reform that integrates pharmacists into primary healthcare clinics can be a potential initiative to promote quality use of medication. This model of care is a novel approach in Malaysia and research in the local context is required, especially from the perspectives of pharmacists.Objective:To explore pharmacists’ views in integrating pharmacists into private GP clinics in Malaysia.Methods:A combination of purposive and snowballing sampling was used to recruit community and hospital pharmacists from urban areas in Malaysia to participate either in focus groups or semi-structured interviews. A total of 2 focus groups and 4 semi-structured interviews were conducted. Sessions were audio recorded, transcribed verbatim and thematically analysed using NVivo 10.Results:Four major themes were identified: (1) Limited potential to expand pharmacists’ roles, (2) Concerns about non-pharmacists dispensing medicines in private GP clinics, (3) Lack of trust from consumers and private GPs, (4) Cost implications. Participants felt that there was a limited role for pharmacists in private GP clinics. This was because the medication supply role is currently undertaken in private GP clinics without the need of pharmacists. The perceived lack of trust from consumers and private GPs towards pharmacists arises from the belief that healthcare is the GPs’ responsibility. This suggests that there is a need for increased public and GP awareness towards the capabilities of pharmacists’ in medication management. Participants were concerned about an increase in cost to private GP visits if pharmacists were to be integrated. Nevertheless, some participants perceived the integration as a means to reduce medical costs through improved quality use of medicines.Conclusion:Findings from the study provided a better understanding to help ascertain pharmacists’ views on their readiness and acceptance in a potential new model of practice.

A qualitative study on the development of pharmacist‐managed clinics in Taiwan

“…Our findings suggest that clarifying the responsibilities would ensure better acceptance of PMCs. These findings resonate with previous observations, which indicated that an ambiguous role of care may contribute to misunderstanding and conflicts with others 16,17 . To consolidate collaboration among participating professionals, possible suggestions are listed to inform future implementations of PMCs.…”

“…Second, there are limited studies regarding PMC clinics from countries other than the United States, UK, Canada and Australia 1 . A few international studies have investigated the operational issues of PMCs or professional relationships between pharmacists and physicians 16,17 . It remains unclear whether the findings from limited countries can be extrapolated to other developing or developed countries, especially due to differences in pharmacy education, technician workforce, healthcare system and differences in patient–provider behaviour.…”

<p>The perspectives of patients and physicians on the role of pharmacists in improving medication adherence in type 2 diabetes: a qualitative study</p>

“…In 2014 and 2017, 250 and 198 pharmacists respectively from Kuwait reported frustration abut their poor image in the eyes of physicians and patients, who see them as dispensers only 13,14. Pharmacists in Malaysia perceived a lack of trust from patients and physicians in their abilities to provide healthcare services 59. In Nigeria, a survey of 1005 pharmacists revealed that the majority believe that the implementation of pharmaceutical care would improve patients’ appreciation of pharmacists 60.…”

The Evolving Role and Impact of Integrating Pharmacists into Primary Care Teams: Experience from Ontario, Canada

“…In jurisdictions such as Malaysia where pharmacist integration is emerging, it is important to leverage evidence from countries where integration of pharmacists was successful, in order to strengthen physician awareness of and support for the significant roles and contributions of pharmacists in PCTs [ 19 , 20 ].…”

“…In the past two decades, the movement to include pharmacists as essential members of PCTs has gained traction in a number of countries, including Canada [ 9 , 11 , 12 ], the United States [ 13 , 14 , 15 ], the United Kingdom [ 16 , 17 ], Australia [ 18 ], Malaysia [ 19 , 20 , 21 ], and Brazil [ 22 ]. Pharmacists integrated into interdisciplinary PCTs globally demonstrated their significant role in many direct patient care activities, including medication management, identifying adverse or incorrect medication usage, counselling on medications, and effectively optimizing a patient’s understanding of their own medication regimens to enhance overall quality of life [ 9 , 23 ].…”