General practitioners’ perceptions of pharmacists working in general practice: a qualitative interview study

Hurley, Eoin; Walsh, Elaine; Foley, Tony; Heinrich, Clara; Byrne, Stephen; Dalton, Kieran

doi:10.1093/fampra/cmac115

Cited by 7 publications

(6 citation statements)

References 36 publications

(45 reference statements)

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“…In the UK, the role of pharmacists in primary care is established, and in Ireland pilot studies of GP-based pharmacists have been conducted [ 44–46 ]. Recent research with GPs in Ireland indicates that there is an interest and appetite for the introduction of clinical pharmacists in General Practice [ 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

Stakeholder perceptions of and attitudes towards problematic polypharmacy and prescribing cascades: a qualitative study

Jennings,

Doherty,

Clyne

et al. 2024

Age and Ageing

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Introduction Problematic polypharmacy is the prescribing of five or more medications potentially inappropriately. Unintentional prescribing cascades represent an under-researched aspect of problematic polypharmacy and occur when an adverse drug reaction (ADR) is misinterpreted as a new symptom resulting in the initiation of a new medication. The aim of this study was to elicit key stakeholders’ perceptions of and attitudes towards problematic polypharmacy, with a focus on prescribing cascades. Methods qualitative one-to-one semi-structured interviews were conducted with predefined key stakeholder groups. Inductive thematic analysis was employed. Results Thirty-one stakeholders were interviewed: six patients, two carers, seven general practitioners, eight pharmacists, four hospital doctors, two professional organisation representatives and two policymakers. Three main themes were identified: (i) ADRs and prescribing cascades—a necessary evil. Healthcare professionals (HCPs) expressed concern that experiencing an ADR would negatively impact patients’ confidence in their doctor. However, patients viewed ADRs pragmatically as an unpredictable risk. (ii) Balancing the risk/benefit tipping point. The complexity of prescribing decisions in the context of polypharmacy made balancing this tipping point challenging. Consequently, HCPs avoided medication changes. (iii) The minefield of medication reconciliation. Stakeholders, including patients and carers, viewed medication reconciliation as a perilous activity due to systemic communication deficits. Conclusion Stakeholders believed that at a certain depth of polypharmacy, the risk that a new symptom is being caused by an existing medication becomes incalculable. Therefore, in the absence of harm, medication changes were avoided. However, medication reconciliation post hospital discharge compelled prescribing decisions and was seen as a high-risk activity by stakeholders.

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Section: Discussionmentioning

confidence: 99%

Stakeholder perceptions of and attitudes towards problematic polypharmacy and prescribing cascades: a qualitative study

Jennings,

Doherty,

Clyne

et al. 2024

Age and Ageing

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“…The survey content was based on the results of a qualitative evidence synthesis [ 10 ] and a TDF-informed interview study [ 12 ]; therefore, this study was able to explore the causal determinants of GPs’ perceptions of pharmacist integration into general practice to inform future interventions better. While the survey utilised a multi-modal dissemination approach to enhance its reach and response rate, responses received via electronic routes could have been more extensive in number.…”

Section: Discussionmentioning

confidence: 99%

“…The survey (Supplementary File 1 ) was initially constructed based on the findings from a qualitative evidence synthesis [ 10 ] and a semi-structured interview study that utilised the Theoretical Domains Framework (TDF) as part of its methods [ 11 , 12 ]. The survey was then reviewed and further developed by consensus discussion amongst research team members, which consisted of three pharmacists (two practising) and two practising GPs.…”

Section: Methodsmentioning

confidence: 99%

GPs’ perceptions of pharmacists working in general practices: A mixed methods survey study

Hurley,

Foley,

Walsh

et al. 2023

European Journal of General Practice

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Background Pharmacists are increasingly incorporated into general practice teams globally and have been shown to positively impact patient outcomes. However, little research to date has focused on determining general practitioners’ (GPs’) perceptions of practice-based pharmacist roles in countries yet to establish such roles. Objectives To explore GPs’ perceptions towards integrating pharmacists into practices and determine if any significant associations were present between GPs’ perceptions and their demographic characteristics. Methods In June 2022, a survey was disseminated to GPs in Ireland via post ( n = 500 in Munster region), Twitter, WhatsApp, and an online GP support and education network. Quantitative data were captured through multiple option and Likert-scale questions and analysed using descriptive and inferential statistics. Qualitative data were captured via free-text boxes, with the open comments analysed using reflexive thematic analysis. Results A total of 152 valid responses were received (24.6% response to postal survey). Overall, GPs welcomed the role of practice-based pharmacists and perceived that they would increase patient safety. Most agreed with practice pharmacists providing medicine information (98%) vs. 23% agreeing with practice pharmacists prescribing independently. Most agreed they would partake in a practice pharmacist pilot (78.6%). The free-text comments described current pressures in general practice, existing relationships with pharmacists, funding and governance strategies, potential roles for pharmacists in general practice, and anticipated outcomes of such roles. Conclusion This study provides a deeper understanding of GPs’ perceptions of integrating pharmacists into practices and the demographic characteristics associated with different perceptions, which may help better inform future initiatives to integrate pharmacists into practices.

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“…This study identified barriers to collaboration between the pharmacist and other health professionals in general practice teams [ 26 , 32 – 34 ]. As general practices have busy schedules, most professionals did not have quality time to interact with the pharmacists and they had relatively limited awareness of the activities that pharmacists could perform in general practice [ 35 ]. Furthermore, interviews and survey findings highlighted that the pharmacists were more active than the GPs in contributing to relationship initiation.…”

Section: Discussionmentioning

confidence: 99%

Interprofessional collaboration within general practice teams following the inclusion of non-dispensing pharmacists

Sudeshika

Deeks

Naunton

et al. 2023

J of Pharm Policy and Pract

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Background Pharmacists have been included in general practice teams to provide non-dispensing services in the Australian Capital Territory (ACT) since 2016. Interprofessional collaboration and team effectiveness are key considerations in providing high-quality patient care. These concepts have not been well studied following the inclusion of a pharmacist in general practice teams. Methods A mixed methods study was conducted to explore collaboration between pharmacists and health professionals in eight general practices in the ACT, where pharmacists were included in their teams. A validated survey instrument was adapted and utilised to assess the changes in interprofessional collaboration over time following the addition of a pharmacist. Another validated survey was utilised to explore team effectiveness at the end of the study. Semi-structured interviews, with a thematic analysis, were conducted with a purposeful sample of general practice staff members to understand the factors influencing the development of interprofessional collaboration. Results In total, 56 and 41 participants completed the baseline and follow-up survey, including 26 who completed both surveys to assess the change in collaboration over time. Interprofessional collaboration scores were high initially and did not change over time. Team effectiveness was also high at the end of the study. Twenty-one individuals participated in interviews, which generated four main interrelated themes related to interprofessional collaboration: professional working relationships, trust, commitment to collaboration, and barriers to collaboration. Trust was integral to professional working relationships and commitment to collaboration. The barriers to collaboration included not having a role description for pharmacists, inadequate interest to initiate working relationships, lack of dedicated time for interaction, lack of utilisation, and poor awareness of pharmacist-led activities in general practice. Conclusion Interprofessional collaboration was initially high and not influenced by the addition of a pharmacist, perhaps reflecting the inherent nature of the general practices willing to include a pharmacist within their team. Introducing a clear job description for pharmacists, and dedicating time to interact with pharmacists, could be beneficial in improving trust and professional working relationships and enhancing collaboration between the pharmacists and other general practice team members.

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General practitioners’ perceptions of pharmacists working in general practice: a qualitative interview study

Cited by 7 publications

References 36 publications

Stakeholder perceptions of and attitudes towards problematic polypharmacy and prescribing cascades: a qualitative study

Stakeholder perceptions of and attitudes towards problematic polypharmacy and prescribing cascades: a qualitative study

GPs’ perceptions of pharmacists working in general practices: A mixed methods survey study

Interprofessional collaboration within general practice teams following the inclusion of non-dispensing pharmacists

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