General practitioner perceptions of clinical medication reviews undertaken by community pharmacists

Abstract

INTRODUCTION: Delivery of current health care services focuses on interdisciplinary teams and greater involvement of health care providers such as nurses and pharmacists. This requires a change in role perception and acceptance, usually with some resistance to changes. There are few studies investigating the perceptions of general practitioners (GPs) towards community pharmacists increasing their participation in roles such as clinical medication reviews. There is an expectation that these roles may be perceived as crossing a clinical boundary between the work of the GP and that of a pharmacist. METHODS: Thirty-eight GPs who participated in the General Practitioner–Pharmacists Collaboration (GPPC) study in New Zealand were interviewed at the study conclusion. The GPPC study investigated outcomes of a community pharmacist undertaking a clinical medication review in collaboration with a GP, and potential barriers. The GPs were exposed to one of 20 study pharmacists. The semi-structured interviews were recorded and transcribed verbatim then analysed using a general inductive thematic approach. FINDINGS: The GP balanced two themes, patient outcomes and resource utilisation, which determined the over-arching theme, value. This concept was a continuum, depending on the balance. Factors influencing the theme of patient outcomes included the clinical versus theoretical nature of the pharmacist recommendations. Factors influencing resource utilisation for general practice were primarily time and funding. CONCLUSION: GPs attributed different values to community pharmacists undertaking clinical medication reviews, but this value usually balanced the quality and usefulness of the pharmacist’s recommendations with the efficiency of the system in terms of workload and funding. KEYWORDS: Family physicians; community pharmacy services; drug utilization review; primary healthcare; health plan implementation; qualitative research; interprofessional relations

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

“…Other studies which have explored different issues related to CP and GP collaboration have found similar results, indicating that this would improve the quality of the prescription (Bryant et al, 2010a;Montgomery et al, 2007;Teinilä, Kaunisvesi, & Airaksinen, 2011) (Dieleman et al, 2004;Howard et al, 2003) and would increase patient trust (Montgomery et al, 2007).…”

“…Factors which influence collaboration are diverse and range from time and funding to those which depend on approach, such as trust and respect (Bradley, Ashcroft, & Noyce, 2012;Hughes & McCann, 2003;Rubio-Valera et al, 2012). One of the most relevant factors in promoting or initiating the GP-CP relationship is the perception that these professionals have regarding the usefulness of the collaboration (Bryant et al, 2010a).…”

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

“…One study combined qualitative interviews and a survey . Studies were conducted in 13 countries, most commonly Australia (n=3), New Zealand (n=3), and the Netherlands (n=3) …”

Completeness of medication reviews provided by community pharmacists

“…Monitoring‐related problems accounted for more than two DRPs per patient, but were mostly assigned a low priority and not followed by a recommendation for drug change. Monitoring‐related problems and some other DRPs identified by expert reviewers might be perceived by community pharmacists and GPs as too theoretical or ‘textbook advice’ . This may partly explain why community pharmacists identified a lower number but relatively more clinically relevant DRPs.…”