General Practitioner Perceptions of Extended Pharmacy Services and Modes of Collaboration with Pharmacists

Abstract

Aims:To explore the perceptions of Australian general practitioners (GPs) towards extended pharmacy services, and to investigate the modes and extent of collaboration between community pharmacists and GPs. Method: Semi-structured face-to-face and telephone interviews were conducted on a purposive sample of GPs from Sydney and surrounding areas. The data were thematically analysed, using qualitative data analysis software. Results: 23/68 (34%) GPs approached, agreed to participate in the interviews. The respondents practised in different settings (private/medical centre/specialised settings, rural/suburban/city areas), had been in professional practice for periods ranging from 6 months to several decades and included both female and male practitioners. Support for pharmacist provision of services varied. GP perceptions were mostly positive for home medicines review (HMR), information provision and monitoring. However, most GPs did not favour pharmacists' provision of screening and immunisation services. Most respondents believed that GPpharmacist collaboration would be beneficial to both the patient and the GP. However, despite this, collaboration was minimal in all extended pharmacy services discussed except HMR. Conclusion: HMR is the extended pharmacy service most widely accepted by GPs and has proved to be an effective platform for inter-professional collaboration. Considering the factors that promote effective collaboration in HMR will position us better to improve the GP-pharmacist collaboration crucial for expanding other extended pharmacy services. J Pharm Pract Res 2007; 37: 182-6.

General practitioner–pharmacist interactions in professional pharmacy services

“…The results of this study indicate that there is very limited collaboration between GPs and pharmacists in primary care in Australia with most interactions relating to the routine dispensing of prescriptions. This is consistent with previous research which indicated that genuine collaborative relationships between GPs and pharmacists, in the community setting, are lacking (Ferlie & Shortell, 2001; Van et al, 2007).…”

“…Research has shown that pharmacists and medical practitioners working together in patient care results in positive health outcomes in cholesterol reduction (Tsuyuki et al, 2002), hypertension (McLean et al, 2008), heart failure (Gattis, Hasselblad, Whellan, & O'Connor, 1999), depression (Landers, Blenkinsopp, Pollock, & Grime, 2002) and medication management (McDonough & Doucette, 2003). Although multidisciplinary care plans which coordinate and integrate treatment and care processes delivered by different HCPs are well established in hospital and ambulatory care, the ability of HCPs to collaborate in primary care seems to vary between practitioners and practitioner teams (Brock & Doucette, 2004; Van, Krass, & Mitchell, 2007). Despite attempts over the years to introduce more collaborative models of practice, most HCPs in primary care continue to work as functionally separate solo practitioners (Dieleman et al, 2004;Dobson et al, 2009).…”

Exploring the nature of power distance on general practitioner and community pharmacist relations in a chronic disease management context

“…GPs were unlikely to readily give community pharmacists clinical information about their patients. This lack of communication and transfer of clinical patient information between GPs and community pharmacists was also perceived to exist by community pharmacists in a study of their involvement in medication management (Dinnie, Bond, & Watson, 2004;Van et al, 2007).…”

“…It is also unclear whether GP and community pharmacist training incorporates relationship building and team working/collaborative training (Shortell & Kaluzny, 2000;Van et al, 2007). Enhanced training in these areas may thus be beneficial in promoting stronger GP/ community pharmacist relationships, thereby increasing the likelihood of successful GP/community pharmacist collaborative CDM.…”

“…Studies of collaboration between GPs and other healthcare professionals, such as dieticians, showed that when GPs perceived that the training and education of the other healthcare professionals was of a standard that could contribute meaningfully to the management of the patient, the GPs were more likely to engage in collaboration with them (Hansson, Friberg, Segesten, Gedda, & Matsson, 2008, Kidd et al, 2006. That is, each team member had to have complementary skills (Xyrichis & Lowton, 2008;Xyrichis & Ream, 2008) and appropriate training leading to the required level of knowledge so that the GP could see that they could contribute to a higher standard of care than the GP could deliver alone (Bradley et al, 2008;Penrose-Wall et al, 2001;Van, Krass, & Mitchell, 2007;Wagner, 2000).…”