scholarly journals Positioning Each Other: A Metasynthesis of Pharmacist-Physician Collaboration

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hilde Rakvaag ◽  
Gunn Elisabeth Søreide ◽  
Reidun Lisbet Skeide Kjome
Keyword(s):  
Health Care ◽  
General Practitioners ◽  
Patient Outcomes ◽  
Interprofessional Collaboration ◽  
Community Pharmacists ◽  
Proactive Approach ◽  
Ethnographic Approach ◽  
Successful Collaboration ◽  
Taking Responsibility

Abstract Interprofessional collaboration between different professions within health care is essential to optimize patient outcomes. Community-pharmacists (CPs) and general-practitioners (GPs) are two professions who are encouraged to increase their collaboration. In this metasynthesis we use a meta-ethnographic approach to examine the interpersonal aspects of this collaboration, as perceived by the professionals themselves. The metasynthesis firstly suggests that CPs and GPs have differing storylines about the cooperation between them. Secondly, CPs seem to position their profession in relation to the GPs, whereas GPs do not rely on the CPs to define their professional position. A successful collaboration between the two professions requires the CPs to reposition themselves through adopting a proactive approach towards the GPs. This proactive approach should comprise the delivery of specific clinical advice, as well as taking responsibility for this advice. In this way, they can build a more coinciding storyline of the joint agenda of improved patientcare.

scholarly journals General practitioner perceptions of clinical medication reviews undertaken by community pharmacists

2010 ◽  
Vol 2 (3) ◽  
pp. 225 ◽  
Author(s):  
Linda Bryant ◽  
Gregor Coster ◽  
Ross McCormick
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Community Pharmacists ◽  
Resource Utilisation ◽  
Utilization Review ◽  
Care Providers ◽  
Factors Influencing ◽  
Medication Reviews

INTRODUCTION: Delivery of current health care services focuses on interdisciplinary teams and greater involvement of health care providers such as nurses and pharmacists. This requires a change in role perception and acceptance, usually with some resistance to changes. There are few studies investigating the perceptions of general practitioners (GPs) towards community pharmacists increasing their participation in roles such as clinical medication reviews. There is an expectation that these roles may be perceived as crossing a clinical boundary between the work of the GP and that of a pharmacist. METHODS: Thirty-eight GPs who participated in the General Practitioner–Pharmacists Collaboration (GPPC) study in New Zealand were interviewed at the study conclusion. The GPPC study investigated outcomes of a community pharmacist undertaking a clinical medication review in collaboration with a GP, and potential barriers. The GPs were exposed to one of 20 study pharmacists. The semi-structured interviews were recorded and transcribed verbatim then analysed using a general inductive thematic approach. FINDINGS: The GP balanced two themes, patient outcomes and resource utilisation, which determined the over-arching theme, value. This concept was a continuum, depending on the balance. Factors influencing the theme of patient outcomes included the clinical versus theoretical nature of the pharmacist recommendations. Factors influencing resource utilisation for general practice were primarily time and funding. CONCLUSION: GPs attributed different values to community pharmacists undertaking clinical medication reviews, but this value usually balanced the quality and usefulness of the pharmacist’s recommendations with the efficiency of the system in terms of workload and funding. KEYWORDS: Family physicians; community pharmacy services; drug utilization review; primary healthcare; health plan implementation; qualitative research; interprofessional relations

scholarly journals Complementing or conflicting? How pharmacists and physicians position the community pharmacist

2020 ◽  
Vol 18 (3) ◽  
pp. 2078
Author(s):  
Hilde Rakvaag ◽  
Gunn E. Søreide ◽  
Eivind Meland ◽  
Reidun L. Kjome
Keyword(s):  
Focus Group ◽  
General Practitioners ◽  
Interprofessional Collaboration ◽  
Community Pharmacists ◽  
Active Role ◽  
Structured Interview ◽  
Study Data ◽  
Positioning Theory ◽  
Focus Group Interviews ◽  
Group Interviews

Background: Interprofessional collaboration between pharmacists and physicians in primary care has been linked to improved patient outcomes. How professionals position themselves and each other can shed light upon their relationship, and positioning theory can be used as a tool to better understand intergroup relations. Objectives: 1) To identify how community pharmacists position themselves, and how they are positioned by general practitioners. 2) To assess how well these positions correspond, how the positions align with a proactive position for the pharmacists, and discuss how the positions could potentially impact collaboration. Methods: In this qualitative study, data were collected through six focus group interviews held between June and October 2019, three with pharmacists and three with physicians. The focus group interviews were conducted using a semi-structured interview guide. Data were audio recorded, transcribed verbatim, and analyzed using the Systematic text condensation method. Positioning theory was used as a theoretical framework to identify the positions assigned to community pharmacists by the pharmacists themselves and by the physicians. Results: Twelve pharmacists and ten physicians participated. The pharmacists positioned themselves as the “last line of defense”, “bridge-builders”, “outsiders” – with responsibility, but with a lack of information and authority – and “practical problem solvers”. The physicians positioned pharmacists as “a useful checkpoint”, “non-clinicians” and “unknown”. Conclusions: The study revealed both commonalities and disagreements in how community pharmacists position themselves and are positioned by general practitioners. Few of the positions assigned to pharmacists by the physicians support an active role for the pharmacists, while the pharmacists´ positioning of themselves is more diverse. The physicians´ positioning of pharmacists as an unknown group represents a major challenge for collaboration. Increasing the two professions´ knowledge of each other may help produce new positions that are more coordinated, and thus more supportive towards collaboration.

scholarly journals Qualitative Study of Community Pharmacists’ and General Practitioners’ Views toward Pharmacovigilance in Lithuania

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1072
Author(s):  
Agne Valinciute-Jankauskiene ◽  
Loreta Kubiliene
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Patient Outcomes ◽  
Medication Management ◽  
Community Pharmacists ◽  
Basic Knowledge ◽  
Pharmacovigilance System ◽  
Face To Face ◽  
Study Approach ◽  
Baltic Countries

Lithuania is the leader in pharmacovigilance among the three Baltic countries. However, comparisons with other European countries are difficult because the reported number of adverse drug reactions (ADRs) in Lithuania is too low to rely on in terms of the annual use of medicines by the population over the year. The aim of this study was to explore challenges related to the understanding and practices of general practitioners and community pharmacists in reporting ADRs in Lithuania. The qualitative study approach of face-to-face interviews was used. All interviews were recorded, transcribed verbatim, and thematically analyzed. Twelve interviews with general practitioners and community pharmacists were conducted from March 2020 through December 2020. All participants had a basic knowledge of pharmacovigilance, but only four participants reported ADRs to the interviewer. Six main barriers regarding ADR reporting were identified, and appropriate interventions were suggested. The importance of collaboration between physicians and pharmacists was highlighted, and the need for guidelines supporting collaboration was expressed. Medications are becoming more complex, and comprehensive medication management is key for the optimization of patient outcomes. Our results reveal the need to improve and innovate the current pharmacovigilance system at all levels, starting from education for pharmacy and healthcare students and continuing through the development of ADR procedures.

Self-help organisations: A qualitative study of successful collaboration with general practice

2003 ◽  
Vol 9 (3) ◽  
pp. 75 ◽  
Author(s):  
Frances M Boyle ◽  
T. Natasha Posner ◽  
Christopher B Del Mar ◽  
Jill McLean ◽  
Robert A Bush
Keyword(s):  
Health Care ◽  
General Practice ◽  
Qualitative Study ◽  
General Practitioners ◽  
Health Care System ◽  
Cross Section ◽  
Structured Interviews ◽  
Self Help ◽  
Successful Collaboration ◽  
Two Sectors

Thousands of self-help organisations (SHOs) exist in Australia but little is known about how they relate to the mainstream health care system. This qualitative study, based in south-east Queensland, aimed to identify examples of collaboration between general practitioners (GPs) and SHOs in order to examine the attributes of successful partnerships. Representatives of six SHOs, identified by key informants as having good collaborative links with GPs, and seven GPs with whom they collaborated, completed semi-structured interviews. The interviews focused on evidence of collaboration and perceptions of benefits and barriers experienced. Maximum variation sampling enabled a cross-section of SHOs in terms of size, funding, and health issue. Although GPs readily identified SHO benefits, they referred patients to them only rarely. SHO credibility, evidence of tangible benefits for patients, ease of contacting the SHO, and correspondence between the SHO?s focus and the GP?s personal and professional interests appear to contribute to the success of partnerships. We conclude that mutually beneficial partnerships between GPs and SHOs exist but are under-utilised. A more coordinated effort is needed to strengthen links between the two sectors.

scholarly journals Pharmacist-Physician Interprofessional Collaboration to Promote Early Detection of Cognitive Impairment: Increasing Diagnosis Rate

2021 ◽  
Vol 12 ◽  
Author(s):  
Hernán Ramos ◽  
Juan Pardo ◽  
Rafael Sánchez ◽  
Esteve Puchades ◽  
Jordi Pérez-Tur ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Early Detection ◽  
Clinical Diagnosis ◽  
General Practitioners ◽  
Interprofessional Collaboration ◽  
Community Pharmacists ◽  
Cognitive Test ◽  
Community Pharmacies

The increased pressure on primary care makes it important for other health care providers, such as community pharmacists, to collaborate with general practitioners in activities related to chronic disease care. Therefore, the objective of the present project was to develop a protocol of action that allows close pharmacist-physician collaboration to carry out a coordinated action for very early detection of cognitive impairment (CI).Methods: A comparative study to promote early detection of CI was conducted in 19 community pharmacies divided into two groups: one group with interprofessional collaboration (IPC) and one group without interprofessional collaboration (NonIPC). IPC was defined as an interactive procedure involving all pharmacists, general practitioners and neurologists. A total of 281 subjects with subjective memory complaints were recruited. Three tests were used in the community pharmacies to detect possible CI: Memory Impairment Screening, Short Portable Mental State Questionnaire, and Semantic Verbal Fluency. Individuals with at least one positive cognitive test compatible with CI, were referred to primary care, and when appropriate, to the neurology service. Finally, we evaluated the differences in clinical and diagnostic follow-up in both groups after six months.Results: The NonIPC study group included 38 subjects compatible with CI referred to primary care (27.54%). Ten were further referred to a neurology department (7.25%) and four of them (2.90%) obtained a confirmed clinical diagnosis of CI. In contrast, in the IPC group, 46 subjects (32.17%) showed results compatible with CI and were referred to primary care. Of these, 21 (14.68%) were subsequently referred to a neurology service, while the remaining 25 were followed up by primary care. Nineteen individuals out of those referred to a neurology service obtained a confirmed clinical diagnosis of CI (13.29%). The percentage of subjects in the NonIPC group referred to neurology and the percentage of subjects diagnosed with CI, was significantly lower in comparison to the IPC group (p-value = 0.0233; p-value = 0.0007, respectively).Conclusions: The creation of IPC teams involving community pharmacists, general practitioners, and neurologists allow for increased detection of patients with CI or undiagnosed dementia and facilitates their clinical follow-up. This opens the possibility of diagnosis in patients in the very early stages of dementia, which can have positive implications to improve the prognosis and delay the evolution of the disease.

scholarly journals Perceptions of interprofessional collaboration of general practitioners and community pharmacists - a qualitative study

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Christin Löffler ◽  
Carolin Koudmani ◽  
Femke Böhmer ◽  
Susanne D. Paschka ◽  
Jennifer Höck ◽  
...  
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Interprofessional Collaboration ◽  
Community Pharmacists

scholarly journals Primary health care practitioner perspectives on the management of insomnia: a pilot study

2014 ◽  
Vol 20 (1) ◽  
pp. 103 ◽  
Author(s):  
Janet M. Y. Cheung ◽  
Kristina Atternäs ◽  
Madeleine Melchior ◽  
Nathaniel S. Marshall ◽  
Romano A. Fois ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Pilot Study ◽  
General Practitioners ◽  
Media Coverage ◽  
Community Pharmacists ◽  
Management Options ◽  
Treatment Pathways ◽  
Prescribing Trends ◽  
Primary Care Practitioners

This paper reports a qualitative pilot study exploring primary care health practitioners’ perspectives on the management of insomnia following the extensive media coverage on the adverse effects of zolpidem in 2007–08. General practitioners and community pharmacists were recruited throughout metropolitan Sydney, New South Wales using a convenience sampling and snowballing technique. Demographic information was collected from each participant followed by a semistructured interview. In total 22 participants were interviewed, including eight general practitioners and 14 community pharmacists. Interview transcripts were analysed using ‘framework analysis’. Participants’ responses illuminated some of the key issues facing primary care practitioners in the management of insomnia. Practitioners perceived there to be an overreliance on pharmacotherapy among insomnia patients and inadequate support for directing patients to alternative treatment pathways if they require or prefer non-pharmacological management. Current prescribing trends appear to favour older benzodiazepines in new cases of insomnia whereas some successful sporadic users of zolpidem have continued to use zolpidem after the media coverage in 2007–08. The findings of this pilot study suggest the need to address the limitations in the management of insomnia within the current health care system, to revise and disseminate updated insomnia guidelines and to provide educational opportunities and resources to primary care practitioners concerning management options.

Dilemmas at a Primary Health Care Center: a baseline study for Computer-Supported Cooperative Health Care Work

1992 ◽  
Vol 31 (03) ◽  
pp. 204-209 ◽  
Author(s):  
T. Timpka ◽  
J. M. Nyce
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
General Practitioners ◽  
Group Process ◽  
Critical Incident ◽  
Care Work ◽  
Work Activity ◽  
Health Care Center ◽  
Health Care Work ◽  
Primary Health

Abstract:For the development of computer-supported cooperative health care work this study investigated, based upon activity theory, daily dilemmas encountered by the members of interprofessional primary health care work groups. The entire staff at four Swedish primary health care centers were surveyed, 199 personal interviews being conducted by the Critical Incident Technique. Medical dilemmas were mainly reported by general practitioners and nurses, organizational dilemmas by laboratory staff, nurses’ aides, and secretaries, and dilemmas in the patient-provider relation by nurses, nurses’ aides, and secretaries. Organizational and communication dilemmas reported by nurses, nurses’ aides, and secretaries often had their cause outside the control of the individual professional. These dilemmas were often “caused” by other group members (general practitioners or nurses), e.g., by not keeping appointment times or by not sharing information with patients. The implication for computer-supported cooperative health care work is that computer support should be planned on two levels. Collective work activity as a whole should benefit from individual clinical decision support for general practitioners and nurses. However, since most patient communication and organizational problems occurred at group level, group process support is required in these areas.

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