Stakeholder experiences with general practice pharmacist services: a qualitative study

Abstract

ObjectivesTo explore general practice staff, pharmacist and patient experiences with pharmacist services in Australian general practice clinics within the Pharmacists in Practice Study.DesignQualitative study.SettingTwo general practice clinics in Melbourne, Australia, in which pharmacists provided medication reviews, patient and staff education, medicines information and quality assurance services over a 6-month period.ParticipantsPatients, practice staff and pharmacists.MethodSemi-structured telephone interviews with patients, focus groups with practice staff and semi-structured interviews and periodic narrative reports with practice pharmacists. Data were analysed thematically and theoretical frameworks used to explain the findings.Results34 participants were recruited: 18 patients, 14 practice staff (9 general practitioners, 4 practice nurses, 1 practice manager) and 2 practice pharmacists. Five main themes emerged: environment; professional relationships and integration; pharmacist attributes; staff and patient benefits and logistical challenges. Participants reported that colocation and the interdisciplinary environment of general practice enabled better communication and collaboration compared to traditional community and consultant pharmacy services. Participants felt that pharmacists needed to possess certain attributes to ensure successful integration, including being personable and proactive. Attitudinal, professional and logistical barriers were identified but were able to be overcome. The findings were explained using D'Amour's structuration model of collaboration and Roger's diffusion of innovation theory.ConclusionsThis is the first qualitative study to explore the experiences of general practice staff, pharmacists and patients on their interactions within the Australian general practice environment. Participants were receptive of colocated pharmacist services, and various barriers and facilitators to integration were identified. Future research should investigate the feasibility and sustainability of general practice pharmacist roles.

Multidisciplinary members’ perspectives on a pharmacist joining a rheumatology practice team

“…In addition, unlike other researchers, we did not evaluate potential patient perspectives; prior reports have identified how patients believed pharmacists involved in their general practice environment care could serve as health advocates. 20 Despite this, we feel that the concepts arising from our work reinforce the importance of prospectively seeking to understand the views and needs of existing care providers and will inform efforts to support successful integration of a pharmacist to this and other specialty practices in the future.…”

“…Medication-related reviews, information and education have been cited as benefits among family physicians in Australia, as well as offering feedback and reassurance to staff. 19,20 Primary health care service delivery in Canada is undergoing expansion, and reform in provinces and territories encompasses development of team-based approaches to clinical care.…”

Advocating for Patients and the Pharmacist's Role in Primary Care

“…MedsChecks, Diabetes MedsChecks and Clinical Interventions by pharmacists), none of which is supported by any evidence in the context of the Australian healthcare setting. Conversely, there is evidence on the value of HMRs to consumers, 2,5,6 a demonstration of cost savings of up to $550 per HMR to the health system, 7-10 and a demonstrable track record that clearly illustrates the delivery of a truly collaborative service between GPs, patients, independent accredited pharmacists and other community or hospitalbased pharmacists [11][12][13][14][15][16][17][18] (Fig. 1).…”

“…Australian studies have demonstrated that HMRs can resolve, manage or reduce medicine-related problems for a wide range of patients. [11][12][13][14][15][16][17][18][19][20][21] In addition, HMRs improve health outcomes; for example, in patients receiving betablockers for heart failure, an HMR resulted in a 45% reduction in likelihood of hospitalisation for heart failure at any time. 18 Another study found that an HMR in patients taking warfarin resulted in a 79% reduced likelihood of bleeding-associated hospitalisation 2-6 months after…”

“…12,13 Recent Australian research by innovators Dr Christopher Freeman and Edwin Tan has reported similar results. [14][15][16][17] Specifically, Freeman has shown that a practice pharmacist increases the timeliness and completion rate of HMRs. 18 Further, this work shows that access to the patient's medical file facilitates a more targeted and less theoretical medication review.…”