Community pharmacist perceptions of clinical medication reviews

Abstract

INTRODUCTION: Changes in delivery of health care services has led to pressure for community pharmacists to extend their traditional role and become more involved with patient-focussed services such as medication reviews, in collaboration with general practitioners (GPs). This has not been generally implemented into routine practice, and many barriers have been suggested that inhibit community pharmacists extending their role. These have often focussed on physical or functional barriers. This study explores possible attitudinal factors that prevent increased participation of community pharmacists in medication reviews undertaken in collaboration with GPs. METHODS: Twenty community pharmacist participants who participated in the General Practitioner– Pharmacist Collaboration (GPPC) study were interviewed. The GPPC study investigated the outcomes of community pharmacists undertaking a clinical medication review in collaboration with GPs, and the potential barriers. Semi-structured interviews were analysed using a general inductive thematic approach. FINDINGS: Emerging themes were that community pharmacists perceived that they were not mandated to undertake this role, it was not a legitimate role, particularly from the business perceptive, and pharmacists were concerned that they lacked the skills and confidence to provide this level of input. CONCLUSION: While there is concern that community pharmacists’ skills are underutilised, there are probable attitudinal barriers inhibiting pharmacists from increasing their role in clinical medication reviews. Perceived legitimacy of the service was a dominant theme, which appeared to be related to issues in the business model. Further investigation should consider the use of a clinical pharmacist working within a general practice independent of a community pharmacy. KEYWORDS: Community pharmacy services; drug utilization review; primary healthcare; health plan implementation

Community Pharmacists' Contribution to Medication Reviews for Older Adults: A Systematic Review

“…Seven articles on clinical medication reviews described 4 different interventions . Three of the articles addressed government‐funded Home Medicines Reviews (HMRs) in Australia and reported studies on 2 approaches to HMRs In the other HMR intervention, community pharmacists interviewed patients to obtain a comprehensive medication profile and, after conducting a review, wrote a report on the HMR findings and recommendations to the GP .…”

“…Eleven studies were not RCTs (intervention studies (n=2), document analyses (n=4), qualitative interviews (n=2), a process description (n=1), a cohort study (n=1), combination of qualitative interviews and a survey). Regardless of community pharmacist contributions to medication review interventions or comprehensiveness of medication review comprehensiveness, interventions led to a reduction in actual or potential DRPs (n=6), better adherence (n=3), and use of fewer medicines (n=2) .…”

“…General Practitioner Pharmacist Collaboration study 15,16,19 Home Medicines Review 17,18 Home Medicines Review 21 Comprehensive Medication Review 22…”

Perceptions of collaboration between general practitioners and community pharmacists: findings from a qualitative study based in Spain

“…In addition, the fact of perceiving collaboration as useful not only influences the willingness to initiate collaboration, but also its continuity (Bryant et al, 2010b). Various studies have indicated that health professionals who collaborate wish to continue doing so as they feel more comfortable in the interaction, communication improves (Dieleman et al, 2004) and an improvement in results is perceived (Laubscher et al, 2009;Teinilä et al, 2011).…”

Community pharmacist patient care services: A systematic review of approaches used for implementation and evaluation

“…[8][9][10][11][12][13][14][15][16] Previous work had primarily focused on service characteristics, [17][18][19] factors associated with service adoption, 13,16,20,21 barriers and facilitators of implementation, 12,22,23 pharmacy culture considerations, 24 and stakeholder perceptions of various services. 25,26 Implementation strategies, or the methods, techniques, and/or activities used to integrate a clinical intervention or patient care service into usual care systematically and purposefully, are a critical area for future scholarly work focused on community pharmacy practice. 27,28 The pharmacy literature suggests that training and compensation have been the most utilized strategies in driving implementation efforts.…”