Physicians and community pharmacists collaboration in primary care: A review of specific models

Bardet, Jean-Didier; Vo, Thi Ha; Bedouch, Pierrick; Allenet, Benoît

doi:10.1016/j.sapharm.2014.12.003

Cited by 86 publications

(73 citation statements)

References 52 publications

(135 reference statements)

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“…17,18 Open and bi-directional communication is also important. 16 Our findings add to the work by Bardet et al by highlighting how the disconnected computer systems and decisions processes limit collaboration between pharmacists and physicians. All participants were enthusiastic about the potential for provincial EHRs to improving information sharing and communication, even when they may not have fully understood where that potential can go which supports Ancker et al findings that patients consider it the responsibility of HCPs to provide information.…”

Section: Discussionsupporting

confidence: 68%

Title: Playing Telephone: Understanding the state of medication decision making in growing healthcare teams in the time of electronic health records (Preprint)

Mercer¹,

Burns²,

Guirguis³

et al. 2018

Preprint

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Background: Primary care needs to be patient-centred, integrated and interprofessional to help patients with complex needs manage the burden of medication-related problems. Considering the growing problem of polypharmacy, there is increasing attention on how and when medicationrelated decisions should be coordinated across multi-disciplinary care teams. Improved knowledge on how integrated EHRs can support interprofessional shared decision-making for medication therapy management is necessary to continue to improve patient care.Objective: This objective of this study was to examine how physicians and pharmacists understand and communicate patient-focused medication information with each other and how this knowledge can influence the design of electronic health records. Methods:This study is part of a broader cross-Canada study between patients and health care providers around how health-related decisions are made and communicated. We visited community pharmacies, team-based primary care clinics, and independent-practice family physician clinics throughout Ontario, Nova Scotia, Alberta, and Quebec. Research assistants conducted semi-structured interviews with physician and pharmacists. A modified version of the Multidisciplinary Framework Method was used to analyze the data. Results:Data was collected at 19 pharmacies and 9 medical clinics and we identified six main themes from 34 health care professionals. First, Interprofessional Shared Decision Making was not occurring and clinicians made decision based on their understanding of the patient. Physicians and pharmacist reported indirect Communication, incomplete Information specifically missing insight into indication and adherence, and misaligned Processes of Care that were further compounded by electronic health records that are not designed to facilitate collaboration. Scope of Practice examined professional and workplace boundaries for pharmacists and physicians that were internally and externally imposed. Physicians decided on the degree of the Physician/Pharmacist Relationship which was often predicated by co-location. Conclusion:When managing medications, there was limited communication and collaboration between primary care providers and pharmacists. Pharmacists were missing key information around reason for use, and physicians required accurate information around adherence. EHRs are a potential tool to help clinicians communicate information to resolve this issue. EHRs need to be designed to facilitate interprofessional medication management, so that pharmacists and physicians move beyond task-based work toward a collaborative approach. In the children's game of telephone, players sit in a circle and whisper a message from ear to ear until the message makes its way around the circle. In most cases, the original message is drastically different by the time it reaches the final player. In clinical settings, medication-related decisions are often passed verbally among patients, doctors, nurses and pharmacists, the message can be similarly distorted...

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Section: Discussionsupporting

confidence: 68%

Title: Playing Telephone: Understanding the state of medication decision making in growing healthcare teams in the time of electronic health records (Preprint)

Mercer¹,

Burns²,

Guirguis³

et al. 2018

Preprint

View full text Add to dashboard Cite

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“…The potential for communication to be facilitated through colocation has also been recognized. 12,13 At the micro level, the importance of role clarity and trusting relationships was highlighted. Hatah and colleagues also reported lack of understanding by general practitioners regarding pharmacists' roles.…”

Section: Discussionmentioning

confidence: 99%

Patient, family physician and community pharmacist perspectives on expanded pharmacy scope of practice: a qualitative study

et al. 2017

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Background:The R x EACH trial was a randomized trial to evaluate the efficacy of community pharmacy-based case finding and intervention in patients at high risk for cardiovascular (CV) events. Community-dwelling patients with poorly controlled risk factors were identified and their CV risk reduced through patient education, prescribing and follow-up by their pharmacist. Perspectives of patients, family physicians and community pharmacists were obtained regarding pharmacists' identification and management of patients at high risk for CV events, to identify strategies to facilitate implementation of the pharmacist's expanded role in routine patient care. Methods:We used a qualitative methodology (individual semistructured interviews) with conventional qualitative content analysis to describe perceptions about community pharmacists' care of patients at high risk for CV events. Perceptions were categorized into macro (structure), meso (institution) and micro (practice) health system levels, based on a conceptual framework of care for optimizing scopes of practice. Results:We interviewed 48 participants (14 patients, 13 family physicians and 21 community pharmacists). Patients were supportive of the expanded scope of practice of pharmacists. All participant groups emphasized the importance of communication, ability to share patient information, trust and better understanding of the roles, responsibilities, accountabilities and liabilities of the pharmacist within their expanded role. Interpretation:Despite support from patients and changes to delivery of care in primary care settings, ongoing efforts are needed to understand how to best harmonize family physician and community pharmacist roles across the health system. This will require collaboration and input from professional associations, regulatory bodies, pharmacists, family physicians and patients. AbstractResearch Research CMAJ OPEN E206CMAJ OPEN, 5(1)

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“…43 Further practical innovations and enhanced collaboration between general practitioners and community pharmacists will be needed to support practice to keep up with evidence. 3,44,45 The high proportion of pharmacists responding to medicines information questions from other health professionals is notable considering there is no remuneration for this role. This suggests it is a role driven by demand and is an established role for pharmacists that is recognised by other health professionals.…”

Section: Discussionmentioning

confidence: 99%

Beyond the four walls: an exploratory survey of location, employment and roles of pharmacists in primary health care

2017

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INTRODUCTION:Recognition of the need to reduce harm and optimise patient outcomes from the use of medicines is contributing to an evolution of pharmacy practice in primary health care internationally. This evolution is changing community pharmacy and leading to new models of care that enable pharmacist contribution beyond traditional realms. There is little information about the extent of these changes in New Zealand. AIM:The aim of this study was to investigate emerging roles of pharmacists in primary health care. METHODS:A 10-question electronic survey was used to collect quantitative data about location, employment and roles of pharmacists practising in primary health care.RESULTS: There were 467 survey responses. Although most pharmacists are employed by (78%, n = 357/458) and located in (84%, n = 393/467) community pharmacies, small numbers are dispersed widely across the primary health care sector. Of the 7% (n = 31/467) working in general practices, most are employed by Primary Health Organisations or District Health Boards. Limited cognitive pharmacy service provision is evident in the sector overall, but is much greater for pharmacists spending time located within general practices. DISCUSSION:The large proportion of pharmacists practising in community pharmacies emphasises the importance of the Community Pharmacy Services Agreement in facilitating increased cognitive pharmacy service provision to optimise patient outcomes. The small numbers of pharmacists located elsewhere in the primary health care sector suggest there is scope to improve collaboration and integration in these areas. Flexible funding models that promote innovation and support sustainable practice change are key.

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Physicians and community pharmacists collaboration in primary care: A review of specific models

Cited by 86 publications

References 52 publications

Title: Playing Telephone: Understanding the state of medication decision making in growing healthcare teams in the time of electronic health records (Preprint)

Title: Playing Telephone: Understanding the state of medication decision making in growing healthcare teams in the time of electronic health records (Preprint)

Patient, family physician and community pharmacist perspectives on expanded pharmacy scope of practice: a qualitative study

Beyond the four walls: an exploratory survey of location, employment and roles of pharmacists in primary health care

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