GPs’ and pharmacists’ views of integrating pharmacists into general practices: a qualitative study

Ibrahim, Ameerah Said Hasan; Barry, Heather E.; Hughes, Carmel

doi:10.3399/bjgp.2022.0518

Cited by 7 publications

(4 citation statements)

References 52 publications

(96 reference statements)

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“…A similar suggestion was previously made regarding a universal system of communication between pharmacists and other primary healthcare providers to improve workflow processes and improve community-based care [ 35 ]. In addition, a qualitative study exploring GPs and pharmacists’ views on integrating pharmacists into general practice emphasised a need to have direct access to GPs [ 36 ]. Therefore, this shows the challenges faced by pharmacists in communicating with GPs and other primary healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study to Establish the Leadership Development Needs of Community Pharmacist Leads in Lambeth, South East London

2023

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Primary care networks (PCNs) are geographical networks consisting of 30,000 to 50,000 patients and groups of general practices working in a multidisciplinary team, including community pharmacists. Community pharmacy (CP) neighbourhood leads act as a conduit between pharmacy contractors and general practitioners (GPs) in these networks, sharing information and providing a voice for the community pharmacy locally. The Lambeth medicines team (NHS South East London Integrated Care Board) recognised the need to continue funding these leadership roles to address barriers to relationship-building between community pharmacies and general practices, the consistency of service delivery and effective communication. The aim of this study was to understand the current experience of CP neighbourhood leads to inform their further development. All eight CP neighbourhood leads individually completed a semi-structured interview over Microsoft Teams, which was then reviewed using content analysis. Ethical approval was received. Leads reported the use of common communication methods such as emails, text messaging applications and telephone calls to engage GPs and pharmacies in their neighbourhoods. Barriers to undertaking their roles included time constraints, delays in responses, high workloads and competing pressures. Other factors impacting their effectiveness and ability to undertake their roles included the scheduling of meetings outside of working hours, finding time during busy working days and organising locum cover on an ad hoc basis. The leads also reported they spent more time focussed on building relationships with their peers and less time focussed on general practice colleagues. Support for CP neighbourhood leads could include ensuring that funded time is protected; communication and technology training; and the provision of more structural support for communication with GPs. The findings of this study can be used to inform future work.

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Section: Discussionmentioning

confidence: 99%

A Pilot Study to Establish the Leadership Development Needs of Community Pharmacist Leads in Lambeth, South East London

2023

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“…Since the COVID-19 pandemic, the role of community pharmacists has evolved rapidly from a service for dispensing medicines to one that actively participates in the treatment of patients by providing key health services and advice to the public [ 63 ]. In several countries, such as Australia [ 64 ] and the UK [ 65 ], there has been some integration of pharmacists into general practice, which has been shown to help optimize prescribing and health outcomes in patients with polypharmacy, as well as to reduce inappropriate prescribing [ 66 ]. With ever-increasing pressure on primary care services, this is a move that is broadly welcomed by GPs, especially with regard to medicine optimization [ 67 ].…”

Section: Role Of the Pharmacistmentioning

confidence: 99%

Proton Pump Inhibitors: Rational Use and Use-Reduction – The Windsor Workshop

Kahrilas,

Anastasiou,

Bredenoord

et al. 2024

Dig Dis

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Background: Despite deprescribing initiatives to curb overutilization of proton pump inhibitors (PPIs), achieving meaningful reductions in PPI use is proving a challenge. Summary: An international group of primary care doctors and gastroenterologists examined the literature surrounding PPI use and use-reduction to clarify: (i) what constitutes rational PPI prescribing; (ii) when and in whom PPI use-reduction should be attempted; and (iii) what strategies to use when attempting PPI use-reduction. Key Messages: Before starting a PPI for reflux-like symptoms, patients should be educated on potential causes and alternative approaches including dietary and lifestyle modification, weight loss, and relaxation strategies. When commencing a PPI, patients should understand the reason for treatment, planned duration, and review date. PPI use at hospital discharge should not be continued without a recognized indication for long-term treatment. Long-term PPI therapy should be reviewed at least annually. PPI use-reduction should be based on the lack of a rational indication for long-term PPI use, not concern for PPI-associated adverse events. PPI use-reduction strategies involving switching to on-demand PPI or dose tapering, with rescue therapy for rebound symptoms, are more likely to succeed than abrupt cessation.

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“…A recent study in Northern Ireland also found that pharmacists not employed by the practice faced some difficulty reconciling competing demands from both employers and practice hosts [25].…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Negotiating new roles in general practice: a qualitative study of clinical pharmacists

Bradley,

Nelson,

Cutts

et al. 2023

Br J Gen Pract

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Background: To address general practice workforce shortages, policy in England has supported the recruitment of ‘non-medical’ roles through reimbursement funding. As one of the first to receive funding, the clinical pharmacist role offers insight into the process of new role negotiation at general practice level. Aim: To identify factors influencing clinical pharmacist role negotiation at practice level, comparing the process under two different funding/employment models. Design and Setting: Qualitative interview study, with staff involved in: 1) the national NHS England Clinical Pharmacists in General Practice scheme and; 2) a local Clinical Commissioning Group funded scheme providing clinical pharmacist support to general practices in one area of Greater Manchester. Method: Semi-structured interviews with purposive and snowball sampling of pharmacists, GPs and practice staff; analysed using Template Analysis. Results: Forty-one interviews were conducted. Four factors were found to influence role negotiation: role ambiguity; competing demands/priorities; level of GP control over the role; and potential for (in)appropriate utilisation of clinical skills. Key differences between the two funding/employment models were the level of influence GPs had in shaping the role and how adaptable pharmacists could be to practice needs. The potential for inappropriate utilisation was reported under both schemes, but most apparent under the role reimbursement, direct employment model of the NHSE scheme. Conclusion: This study highlights lessons applicable for the introduction of non-medical roles more widely in general practice. It provides insight into the factors that can influence role negotiation at practice level and how different funding/employment models can impact on this process.

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GPs’ and pharmacists’ views of integrating pharmacists into general practices: a qualitative study

Cited by 7 publications

References 52 publications

A Pilot Study to Establish the Leadership Development Needs of Community Pharmacist Leads in Lambeth, South East London

A Pilot Study to Establish the Leadership Development Needs of Community Pharmacist Leads in Lambeth, South East London

Proton Pump Inhibitors: Rational Use and Use-Reduction – The Windsor Workshop

Negotiating new roles in general practice: a qualitative study of clinical pharmacists

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