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Nordmann K, Redlich MC, Schaller M, Sauter S, Fischer F. Toward a Conceptual Framework for Digitally Supported Communication, Coordination, Cooperation, and Collaboration in Interprofessional Health Care: Scoping Review. J Med Internet Res 2025; 27:e69276. [PMID: 40418789 DOI: 10.2196/69276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 12/20/2024] [Accepted: 12/21/2024] [Indexed: 05/28/2025] Open
Abstract
BACKGROUND Digital tools for communication, coordination, cooperation, and collaboration (D4C), including electronic health records and specialized apps, are increasingly used in health care to ensure continuity of care across professional boundaries. Despite their growing adoption, there is a lack of precise and clear definitions, and no common understanding of D4C within health care. OBJECTIVE This study aims to explore the concepts and definitions of digitally supported communication, coordination, cooperation, and collaboration by mapping the individual attributes to build a foundation for the operationalization of these concepts and to generate a clear and precise understanding of these concepts in research, practice, and policy. METHODS A scoping review was conducted across MEDLINE, CINAHL, Embase, PsycINFO, and Scopus to identify studies on D4C. We included peer-reviewed studies in English, French, German, Portuguese, and Spanish published since 2012. Definitions of the modes of interaction (communication, coordination, cooperation, and collaboration) and the digital tool supporting these interactions, along with their definitions in cited references, were extracted and analyzed. RESULTS Of the 407 identified papers addressing D4C, 6.1% (n=25) defined the digital concept and 6.6% (n=27) defined the interaction supported by the digital tool, with even fewer being backed by a reference. The analysis of the definitions revealed a hierarchical framework, detailing dimensions, requisites, and goals for each mode of interaction and the digital tool. It delineates progression from communication to collaboration: communication enables the exchange of information; coordination involves organizing people, resources, and activities; cooperation focuses on dividing tasks to achieve shared goals; and collaboration, at the apex, involves jointly addressing care needs. Each mode of interaction can be supported by digital tools. CONCLUSIONS The proposed framework offers a structured approach to establish a shared understanding of the concept of D4C. This unified understanding can serve as a foundation for developing objectives related to the implementation and evaluation of digital tools aimed at fostering interprofessional interactions in health care. As such, it can inform stakeholders in their understanding of D4C, possibly improving workflows and patient care. Further research is needed to operationalize and validate the framework across health care settings. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/45179.
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Affiliation(s)
- Kim Nordmann
- Bavarian Research Center for Digital Health and Social Care, Kempten, Germany
| | | | - Michael Schaller
- Bavarian Research Center for Digital Health and Social Care, Kempten, Germany
| | - Stefanie Sauter
- Bavarian Research Center for Digital Health and Social Care, Kempten, Germany
| | - Florian Fischer
- Bavarian Research Center for Digital Health and Social Care, Kempten, Germany
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Jairoun AA, Al-Hemyari SS, El-Dahiyat F, Shahwan M, Zyoud SH, Jeroudy H, Al Kazhali M, Al-Tamimi SK. Translation, adaptation, and validation of the professional collaborative practice tool for community pharmacists and physicians in Arabic-speaking countries. J Am Pharm Assoc (2003) 2025; 65:102386. [PMID: 40058497 DOI: 10.1016/j.japh.2025.102386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 03/04/2025] [Accepted: 03/04/2025] [Indexed: 05/24/2025]
Abstract
BACKGROUND The importance of collaboration between physicians and community pharmacists in health care is increasingly recognized. Enhanced cooperation positively impacts medication management and patient outcomes by merging medical and pharmaceutical expertise for improved health care. Previously, the Professional Collaborative Practice Tool, which is crucial for assessing such collaboration, was unavailable in Arabic. This study aimed to translate, culturally adapt, and validate the tool in Arabic-speaking countries while focusing on community pharmacists' perspectives on collaborative practice with physicians. METHODS The study, which spanned 10 months, involved a cross-sectional survey of 303 community pharmacists across Arabic-speaking nations. The translation process followed the standard "forward-backward" technique from English to Arabic. Validation employed confirmatory factor analysis (CFA) and structural equation modeling, with indices like root mean square error of approximation (RMSEA), incremental fit index (IFI), normed fit index, McDonald's fit index (MEI), and comparative fit index (CFI). Convergent validity was assessed using average variance extracted (AVE) and composite reliability (CR), while discriminant validity was evaluated through latent factor correlation in the three-factor model against the square root of AVE values. Reliability was gauged using Cronbach's alpha and the intraclass correlation coefficient (ICC). RESULTS CFA confirmed the Professional Collaborative Practice Tool's structural validity in Arabic. The model's robustness was indicated by fit indices (CFI: 0.974, NMI: 0.954, IFI: 0.974, MEI: 0.887, RMSEA: 0.063). AVE values exceeding 0.50 validated the explanatory power of the latent constructs. CR values (≥0.70) indicated strong internal consistency and reliability. The tool demonstrated superior discriminant validity with lower interfactor correlations than the square root of AVE values. High Cronbach's alpha coefficients (>0.70) across all factors and the model reflected excellent internal consistency. The ICC (0.95) suggested exceptional long-term reliability. CONCLUSION This study successfully translated, validated, and enhanced an instrument measuring collaborative practice among community pharmacists in Arabic-speaking countries. The tool effectively assesses collaboration levels crucial for services like comprehensive medication reviews, thereby influencing patient outcomes. It supports the essential role of strengthening the partnership between physicians and community pharmacists in delivering patient-centered health care services. The validated instrument can be incorporated into regular assessments in community pharmacies to monitor and improve collaborative behaviors.
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Schillok H, Gensichen J, Panagioti M, Gunn J, Junker L, Lukaschek K, Jung-Sievers C, Sterner P, Kaupe L, Dreischulte T, Ali MK, Aragonès E, Bekelman DB, Herbeck Belnap B, Carney RM, Chwastiak LA, Coventry PA, Davidson KW, Ekstrand ML, Flehr A, Fletcher S, Hölzel LP, Huijbregts K, Mohan V, Patel V, Richards DA, Rollman BL, Salisbury C, Simon GE, Srinivasan K, Unützer J, Wells KB, Zimmermann T, Bühner M. Effective Components of Collaborative Care for Depression in Primary Care: An Individual Participant Data Meta-Analysis. JAMA Psychiatry 2025:2831899. [PMID: 40136273 PMCID: PMC11947969 DOI: 10.1001/jamapsychiatry.2025.0183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2024] [Accepted: 12/23/2024] [Indexed: 03/27/2025]
Abstract
Importance Collaborative care is a multicomponent intervention for patients with chronic disease in primary care. Previous meta-analyses have proven the effectiveness of collaborative care for depression; however, individual participant data (IPD) are needed to identify which components of the intervention are the principal drivers of this effect. Objective To assess which components of collaborative care are the biggest drivers of its effectiveness in reducing symptoms of depression in primary care. Data Sources Data were obtained from MEDLINE, Embase, Cochrane Library, PubMed, and PsycInfo as well as references of relevant systematic reviews. Searches were conducted in December 2023, and eligible data were collected until March 14, 2024. Study Selection Two reviewers assessed for eligibility. Randomized clinical trials comparing the effect of collaborative care and usual care among adult patients with depression in primary care were included. Data Extraction and Synthesis The study was conducted according to the IPD guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. IPD were collected for demographic characteristics and depression outcomes measured at baseline and follow-ups from the authors of all eligible trials. Using IPD, linear mixed models with random nested effects were calculated. Main Outcomes and Measures Continuous measure of depression severity was assessed via validated self-report instruments at 4 to 6 months and was standardized using the instrument's cutoff value for mild depression. Results A total of 35 datasets with 38 comparisons were analyzed (N = 20 046 participants [57.3% of all eligible, with minimal differences in baseline characteristics compared with nonretrieved data]; 13 709 [68.4%] female; mean [SD] age, 50.8 [16.5] years). A significant interaction effect with the largest effect size was found between the depression outcome and the collaborative care component therapeutic treatment strategy (-0.07; P < .001). This indicates that this component, including its key elements manual-based psychotherapy and family involvement, was the most effective component of the intervention. Significant interactions were found for all other components, but with smaller effect sizes. Conclusions and Relevance Components of collaborative care most associated with improved effectiveness in reducing depressive symptoms were identified. To optimize treatment effectiveness and resource allocation, a therapeutic treatment strategy, such as manual-based psychotherapy or family integration, may be prioritized when implementing a collaborative care intervention.
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Affiliation(s)
- Hannah Schillok
- Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Graduate Program, POKAL—Predictors and Outcomes in Primary Care Depression Care, Munich, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Graduate Program, POKAL—Predictors and Outcomes in Primary Care Depression Care, Munich, Germany
- German Center for Mental Health, Munich/Augsburg, Germany
| | - Maria Panagioti
- National Institute of Health and Care Research (NIHR) School for Primary Care Research, NIHR Greater Manchester Patient Safety Research Collaborations, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
- National Institute of Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, United Kingdom
| | - Jane Gunn
- Department of General Practice and Primary Care, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lukas Junker
- Graduate Program, POKAL—Predictors and Outcomes in Primary Care Depression Care, Munich, Germany
- Department of Psychology, LMU Munich, Munich, Germany
| | - Karoline Lukaschek
- Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Graduate Program, POKAL—Predictors and Outcomes in Primary Care Depression Care, Munich, Germany
| | - Caroline Jung-Sievers
- Graduate Program, POKAL—Predictors and Outcomes in Primary Care Depression Care, Munich, Germany
- Institute of Medical Information Processing, Biometry and Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health Munich, Munich, Germany
| | - Philipp Sterner
- Department of Psychology, LMU Munich, Munich, Germany
- German Center for Mental Health, Bochum, Germany
| | - Lukas Kaupe
- Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Graduate Program, POKAL—Predictors and Outcomes in Primary Care Depression Care, Munich, Germany
| | - Tobias Dreischulte
- Institute of General Practice and Family Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Graduate Program, POKAL—Predictors and Outcomes in Primary Care Depression Care, Munich, Germany
| | - Mohammed K. Ali
- Emory Global Diabetes Research Center, Woodruff Health Sciences Center and Emory University, Atlanta, Georgia
- Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Georgia
| | - Enric Aragonès
- Institut Universitari d’Investigació en Atenció Primària Jordi Gol, Barcelona, Spain
| | - David B. Bekelman
- Department of Medicine, Eastern Colorado Health Care System, Denver
- Division of General Internal Medicine, Department of Medicine, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora
- Department of Veterans Affairs, Eastern Colorado Health Care System, Denver
| | - Birgit Herbeck Belnap
- Center for Behavioral Health, Media, and Technology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Robert M. Carney
- Department of Psychiatry, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Lydia A. Chwastiak
- Department of Global Health, University of Washington, Seattle
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Peter A. Coventry
- Mental Health and Addiction Research Group, Department of Health Sciences, University of York, York, United Kingdom
- York Environmental Sustainability Institute, University of York, York, United Kingdom
| | | | - Maria L. Ekstrand
- Division of Mental Health and Neurosciences, St John’s Research Institute, Bengaluru, India
- Division of Prevention Sciences, Department of Medicine, University of California, San Francisco
| | - Alison Flehr
- Department of General Practice and Primary Care, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Susan Fletcher
- Department of General Practice and Primary Care, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lars P. Hölzel
- Health Services Research, Oberberg Clinic Group, Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
- Department of Psychiatry and Psychotherapy, Medical Center–University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Klaas Huijbregts
- Scelta (part of GGNet Mental Health Care), Apeldoorn, Warnsveld, the Netherlands
| | - Viswanathan Mohan
- Department of Diabetology, Madras Diabetes Research Foundation and Dr Mohan’s Diabetes Specialities Centre, Chennai, India
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts
| | - David A. Richards
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Bruce L. Rollman
- Center for Behavioral Health, Media, and Technology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Chris Salisbury
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Krishnamachari Srinivasan
- Division of Mental Health and Neurosciences, St John’s Research Institute, Bengaluru, India
- Department of Psychiatry, St John’s Medical College, Bengaluru, India
| | - Jürgen Unützer
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Kenneth B. Wells
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
| | - Thomas Zimmermann
- Department of General Practice and Primary Care, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Bühner
- Graduate Program, POKAL—Predictors and Outcomes in Primary Care Depression Care, Munich, Germany
- German Center for Mental Health, Munich/Augsburg, Germany
- Department of Psychology, LMU Munich, Munich, Germany
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Meijvis VAM, Heringa M, Kwint HF, de Wit NJ, Bouvy ML. Factors influencing the implementation of the CombiConsultation in Dutch clinical practice: a mixed-methods study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2024; 32:347-354. [PMID: 39018025 DOI: 10.1093/ijpp/riae032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/26/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE The CombiConsultation is an innovative concise clinical pharmacy service by the community pharmacist for patients with a chronic condition. We aimed to identify relevant factors influencing the implementation of the CombiConsultation in Dutch clinical practice. METHODS A mixed-methods study involving interviews and a questionnaire. Content analysis topics within TDF domains were derived from the interview data and were related to the COM-B-model (capability-opportunity-motivation-Behaviour). The relevance of the resulting topics was explored using a questionnaire with 19 statements administered to all 27 pharmacists who performed CombiConsultations. KEY FINDINGS Eighteen topics emerged from the interviews. The questionnaire was completed by 23 of the 27 pharmacists. In the domain 'capability', a small number of participants indicated that they need more expertise in pharmacotherapy (13%) and training in consultation skills (35%). In the domain 'opportunity', all participants indicated that an existing good collaboration with the general practitioner/practice nurse and access to all relevant medical data were necessary to implement the CombiConsultation. In terms of motivation, job satisfaction was most important to all participants, followed by adequate reimbursement (83%) and improving collaboration with other healthcare providers and the relationship with patients (78%). CONCLUSIONS Capability, opportunity, and motivation were all considered relevant for the implementation of the CombiConsultation. There were crucial factors on the level of the individual pharmacist, on the level of the local collaboration and organization, and on the health system level.
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Affiliation(s)
- Valérie A M Meijvis
- SIR Institute for Pharmacy Practice and Policy, 2331 JE Leiden, The Netherlands
- Department of Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
| | - Mette Heringa
- SIR Institute for Pharmacy Practice and Policy, 2331 JE Leiden, The Netherlands
| | - Henk-Frans Kwint
- SIR Institute for Pharmacy Practice and Policy, 2331 JE Leiden, The Netherlands
| | - Niek J de Wit
- Department of General Practice, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, 3584 CG Utrecht, The Netherlands
| | - Marcel L Bouvy
- Department of Pharmaceutical Sciences, Utrecht University, 3584 CG Utrecht, The Netherlands
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Lüthold RV, Cateau D, Jenkinson SP, Streit S, Jungo KT. Pharmacists' attitudes towards interprofessional collaboration to optimise medication use in older patients in Switzerland: a survey study. BMC Health Serv Res 2024; 24:849. [PMID: 39061037 PMCID: PMC11282592 DOI: 10.1186/s12913-024-11339-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/22/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Collaboration between physicians and pharmacists facilitates the conduct of medication optimisation efforts. In the context of deprescribing, pharmacists' roles are often described as making deprescribing recommendations to physicians. Little is known about factors associated with pharmacists' willingness to make deprescribing recommendations and their interprofessional collaboration with physicians in Swiss primary care settings. OBJECTIVE To explore pharmacists' perspectives on medication optimisation and deprescribing in older adults, and their preferences for interprofessional collaboration in Swiss primary care settings. METHODS In this cross-sectional study, a random sample of 1000 pharmacist members of the Swiss Pharmacists Association pharmaSuisse was invited to participate in a survey on medication optimisation, deprescribing, and interprofessional collaboration. The survey contained three case vignettes of multimorbid patients with polypharmacy aged ≥ 80 years old, with different levels of dependency in activities in daily living (ADL) and cardiovascular disease (CVD). For each case vignette, pharmacists were asked if and which medications they would deprescribe. We calculated proportions of pharmacists' willingness to deprescribe by case vignette and performed a multilevel logistic regression to assess associations between CVD, ADL, and willingness to deprescribe. RESULTS One hundred thirty-eight (14%) pharmacists responded to the survey: 113 (82%) were female, their mean age was 44 years (SD = 11), and 66% (n = 77) reported having never received any specific training on how to conduct structured medication reviews. Eighty-three (72%) pharmacists reported to be confident in identifying deprescribing opportunities. All pharmacists were willing to deprescribe ≥ 1 medication in all vignettes. Patients with CVD were at lower odds of having medications deprescribed (OR = 0.27, 95%CI 0.21 to 0.36). Willingness to deprescribe was lower with higher dependency in ADL (medium versus low dependency: OR = 0.68, 95%CI 0.54 to 0.87, high versus low dependency: OR = 0.72, 95%CI 0.56 to 0.91). However, the effect of dependency in ADL on willingness to deprescribe was significantly modified by the history of CVD. One hundred five pharmacists (97%) reported to interact with physicians to clarify questions regarding prescriptions at least once a week and 88 (81%) wished to be more involved in deprescribing and medication review. CONCLUSION Pharmacists were willing to make deprescribing suggestions for older patients with polypharmacy, but two-thirds reported having received no formal training on how to perform structured medication reviews. Pharmacists would like to be more involved in the process of medication review and deprescribing, which should be leveraged in the context of Swiss primary care settings.
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Affiliation(s)
- Renata Vidonscky Lüthold
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland
| | - Damien Cateau
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 1015, Lausanne, Switzerland
| | - Stephen Philip Jenkinson
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, 1015, Lausanne, Switzerland
| | - Sven Streit
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland
| | - Katharina Tabea Jungo
- Institute of Primary Health Care (BIHAM), University of Bern, 3012, Bern, Switzerland.
- Division of Pharmacoepidemiology and Pharmacoeconomics and Center for Healthcare Delivery Sciences (C4HDS), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 02115, MA, Boston, USA.
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Babu D, Marotti S, Rowett D, Lim R, Wisdom A, Kalisch Ellett L. What is impacting clinical pharmacists' participation in an interprofessional ward round: a thematic analysis of a national survey. J Interprof Care 2024; 38:444-452. [PMID: 38151971 DOI: 10.1080/13561820.2023.2289506] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/25/2023] [Indexed: 12/29/2023]
Abstract
The ward round (WR) is an important opportunity for interprofessional interaction and communication enabling optimal patient care. Pharmacists' participation in the interprofessional WR can reduce adverse drug events and improve medication appropriateness and communication. WR participation by clinical pharmacists in Australia is currently limited. This study aims to explore what is impacting clinical pharmacists' participation in WRs in Australian hospitals. A self-administered, anonymous national survey of Australian clinical pharmacists was conducted. This study describes the outcomes from qualitative questions which were analyzed thematically in NVivo-2020 according to Braun and Clarke's techniques. Five themes were constructed: "Clinical pharmacy service structure", "Ward round structure", "Pharmacist's capabilities", "Culture" and "Value". A culture supportive of pharmacist's contribution with a consistent WR structure and flexible delivery of clinical pharmacy services enabled pharmacists' participation in WR. Being physically "absent" from the WR due to workload, workflow, and self-perception of the need for extensive clinical knowledge can limit opportunities for pharmacists to proactively contribute to medicines decision-making with physicians to improve patient care outcomes. Bidirectional communication between the interprofessional team and the pharmacist, where there is a co-construction of each individual's role in the WR facilitates consistent and inter-dependent collaborations for effective medication management.
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Affiliation(s)
- Dona Babu
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Sally Marotti
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Debra Rowett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Alice Wisdom
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Lisa Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Batten M, Lewis J, Naunton M, Strickland K, Kosari S. Interprofessional collaboration between prescribers, managers, nursing staff and on-site pharmacists within residential aged care facilities: a mixed-methods study. Age Ageing 2023; 52:afad143. [PMID: 37598408 DOI: 10.1093/ageing/afad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND A new on-site pharmacist (OSP) intervention within residential aged care facilities (RACFs) is being investigated to help improve medication management. Interprofessional collaboration amongst prescribers, nursing staff and pharmacists is critical to improving RACF medication management. OBJECTIVE To explore the extent of interprofessional collaboration and the nature of the working relationships between OSPs and prescribers, managers and nursing staff. METHODS A mixed-methods study was undertaken within the context of a 12-month cluster randomised controlled trial. Semi-structured interviews were conducted with data analysed using framework analysis, and a survey based upon the Physician-Pharmacist Collaboration Index (PPCI) was distributed at two time points (T1 at 3 months and T2 at 9 months after OSP commencement) across seven intervention RACFs. RESULTS The qualitative data (n = 33 interviews) findings related to the processes supportive of these relationships e.g. on-site proximity, OSP personality and perceived (or beneficial) benefits of OSPs working with health care team members (such as OSPs being trusted and providing reassurance to RACF health care team members). The PPCI survey mean scores at T1 (n = 33) and T2 (n = 19) suggested that OSPs were able to establish positive working relationships at 3 months and that positive relationships also existed at 9 months. The integrated findings suggested that the working relationships between OSPs and health care team members were generally positive. CONCLUSIONS This study is the first to explore interprofessional collaboration between OSPs and health-care team members in RACFs. The findings suggest that OSPs can positively contribute to interprofessional collaborative care within RACFs.
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Affiliation(s)
- Miranda Batten
- Health Research Institute, University of Canberra, Bruce, ACT 2617, Australia
| | - Joanne Lewis
- School of Nursing and Health, Avondale University, Wahroonga, NSW 2076, Australia
| | - Mark Naunton
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
| | - Karen Strickland
- School of Nursing, Midwifery and Public Health, University of Canberra, Bruce, ACT 2617, Australia
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA 6207, Australia
| | - Sam Kosari
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
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Hasan Ibrahim AS, Barry HE, Hughes CM. GPs' and pharmacists' views of integrating pharmacists into general practices: a qualitative study. Br J Gen Pract 2023; 73:e407-e417. [PMID: 37230784 DOI: 10.3399/bjgp.2022.0518] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/14/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Practice-based pharmacists (PBPs) have been introduced into general practice across the UK to relieve some of the pressures within primary care. However, there is little existing UK literature that has explored healthcare professionals' (HCPs') views about PBP integration and how this role has evolved. AIM To explore the views and experiences of GPs, PBPs, and community pharmacists (CPs) about PBPs' integration into general practice and their impact on primary healthcare delivery. DESIGN AND SETTING A qualitative interview study in primary care in Northern Ireland. METHOD Purposive and snowball sampling were used to recruit triads (a GP, a PBP, and a CP) from across five administrative healthcare areas in Northern Ireland. Sampling of practices to recruit GPs and PBPs commenced in August 2020. These HCPs identified the CPs who had most contact with the general practices in which the recruited GPs and PBPs were working. Semi-structured interviews were recorded, transcribed verbatim, and analysed using thematic analysis. RESULTS Eleven triads were recruited from across the five administrative areas. Four main themes in relation to PBPs' integration into general practices were revealed: evolution of the role; PBP attributes; collaboration and communication; and impact on care. Areas for development were identified such as patient awareness of the PBP role. Many saw PBPs as a 'central hub-middleman' between general practice and community pharmacies. CONCLUSION Participants reported that PBPs had integrated well and perceived a positive impact on primary healthcare delivery. Further work is needed to increase patient awareness of the PBP role.
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Affiliation(s)
- Ameerah S Hasan Ibrahim
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan, and researcher, Primary Care Research Group, School of Pharmacy, Queen's University Belfast, Belfast, UK
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Bodein I, Forestier M, Le Borgne C, Lefebvre JM, Pinçon C, Garat A, Standaert A, Décaudin B. [Evaluation of simulation-based training program intended to improve interprofessional communication skills of community pharmacy and general medicine students]. ANNALES PHARMACEUTIQUES FRANÇAISES 2023; 81:354-365. [PMID: 35792148 DOI: 10.1016/j.pharma.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/30/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objective of this work is to assess the impact of a simulation session on the ability of pharmacy and medicine students in general practice to communicate in the resolution of patient-facing situations. METHODS The evaluation of the impact of the session on the representation of the professions used a questionnaire to be completed before and after the session by the students. The evaluation of the impact of the session on the perception of communication and associated skills was based on an audio recording of the debriefings, which, after transcription and thematic analysis, was used as a preliminary analysis for the drafting of a questionnaire proposed the following year. This questionnaire focused on the issues of interprofessional communication and on the seminar process. RESULTS During the 2018 and 2019 seminars, 518 students attended, 39% were pharmacy students (n=201) and 61% were medical students (n=317). The majority of medical students initially responded that physician-pharmacist communication was confraternal and rare. More pharmacy students felt that the quality of the physician-pharmacist relationship was poor. However, there was a marked improvement for all students on this aspect of communication after the seminar. Both groups also generally agreed that this relationship could be improved. CONCLUSIONS The evaluation shows that an interprofessional simulation program improves the ability of pharmacy and general practice students to communicate in patient-facing situations.
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Affiliation(s)
- I Bodein
- Département de médecine générale, faculté de médecine, university Lille, UFR3S, 59000 Lille, France
| | - M Forestier
- Département de médecine générale, faculté de médecine, university Lille, UFR3S, 59000 Lille, France
| | - C Le Borgne
- Département de médecine générale, faculté de médecine, university Lille, UFR3S, 59000 Lille, France
| | - J-M Lefebvre
- Département de médecine générale, faculté de médecine, university Lille, UFR3S, 59000 Lille, France
| | - C Pinçon
- Département de pharmacie officinale, faculté de pharmacie, university Lille, UFR3S, 59000 Lille, France; ULR2694 (METRICS : évaluation des technologies de santé et des pratiques médicales), university Lille, CHU Lille, 59000 Lille, France
| | - A Garat
- Département de pharmacie officinale, faculté de pharmacie, university Lille, UFR3S, 59000 Lille, France; Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'environnement chimique sur la santé, university Lille, CHU Lille, 59000 Lille, France
| | - A Standaert
- Département de pharmacie officinale, faculté de pharmacie, university Lille, UFR3S, 59000 Lille, France; Inserm, U1286 - INFINITE - Institute for translational research in inflammation, university Lille, CHU Lille, 59000 Lille, France
| | - B Décaudin
- Département de pharmacie officinale, faculté de pharmacie, university Lille, UFR3S, 59000 Lille, France; ULR 7365 - GRITA - Groupe de recherche sur les formes injectables et les technologies associées, university Lille, CHU Lille, 59000 Lille, France.
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Rakvaag H, Kjome RLS, Elisabeth Søreide G. Power dynamics and interprofessional collaboration: How do community pharmacists position general practitioners, and how do general practitioners position themselves? J Interprof Care 2023:1-8. [PMID: 36597594 DOI: 10.1080/13561820.2022.2148637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 01/05/2023]
Abstract
Power differentials and medical dominance can negatively affect collaboration between physicians and pharmacists. Norway is recognized as having a relatively egalitarian work sector, which could affect power differentials. In this qualitative study, we used positioning theory as a framework to explore the aspect of power dynamics between Norwegian general practitioners (GPs) and community pharmacists. We used the concepts of reflexive and interactive positioning to identify how GPs positioned themselves and how they were positioned by pharmacists in six focus groups. Data were analyzed using systematic text condensation. We found positioning theory to be a useful lens through which to study power dynamics in relation to collaboration between community pharmacists and GPs. Our findings imply that the presence of medical dominance poses challenges even in an egalitarian Norwegian setting. However, although both GPs and pharmacists draw on a 'medical dominance' storyline, we have also identified how both pharmacists and GPs draw on alternative and promising storylines of collaboration between the two professions.
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Affiliation(s)
- Hilde Rakvaag
- Department of Global Public Health and Primary care/Centre for Pharmacy, University of Bergen, Bergen, Norway
| | - Reidun Lisbet Skeide Kjome
- Department of Global Public Health and Primary care/Centre for Pharmacy, University of Bergen, Bergen, Norway
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11
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Percival M, Freeman C, Cottrell N. Feasibility of a collaborative pharmacist prescribing model for patients with chronic disease(s) attending Australian general practices: a preliminary study. Int J Clin Pharm 2022; 45:502-508. [PMID: 36342565 DOI: 10.1007/s11096-022-01488-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/12/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pharmacists working in general practices provide medication reviews with recommendations to general practitioners (GPs) to optimise medications. We describe a model where the pharmacist is empowered with increased responsibility to implement agreed recommendations through collaborative prescribing. AIM To assess a collaborative pharmacist prescribing model incorporating increased pharmacist responsibility, for patients with chronic diseases in general practice. METHOD This was a pre-test-post-test quasi experimental pilot study using a pharmacist embedded in three Australian general practices. A pharmaceutical care plan was developed with patients and their GP to identify drug related problems (DRPs). The pharmacist discussed recommendations to manage DRPs with the GP and implemented recommendations agreed by the GP and patient over the six-month study period. Outcome measures included acceptance and implementation rate of recommendations made by the pharmacist. RESULTS The pharmacist made 135 recommendations to optimise medicine use of which 126 (93.3%) were accepted by the GP. There were 105 (83.3%) implemented by the end of the study of which the pharmacist implemented 62 (49.3%). CONCLUSION Compared to other Australian studies using a general practice pharmacist model, this study suggested increased pharmacist responsibility through collaborative prescribing led to high acceptance and implementation rates of recommendations to manage DRPs.
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Affiliation(s)
- Matthew Percival
- School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, 20 Cornwall Street, Woolloongabba, Brisbane, QLD, 4102, Australia.
- Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport, QLD, 4215, Australia.
| | - Christopher Freeman
- School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, 20 Cornwall Street, Woolloongabba, Brisbane, QLD, 4102, Australia
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4072, Australia
- Metro North Health, Brisbane, QLD, 4029, Australia
| | - Neil Cottrell
- School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, 20 Cornwall Street, Woolloongabba, Brisbane, QLD, 4102, Australia
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12
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White A, Fulda KG, Blythe R, Chui MA, Reeve E, Young R, Espinoza A, Hendrix N, Xiao Y. Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety. Expert Opin Drug Saf 2022; 21:1357-1364. [PMID: 36377503 PMCID: PMC9850835 DOI: 10.1080/14740338.2022.2147923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Over 4 billion prescriptions are dispensed each year to patients in the United States, with the number of prescriptions continuing to increase. There is a growing recognition of pharmacists' potential in improving medication safety in community settings, in collaboration with primary care providers (PCPs). However, the nature of collaboration has not been well defined, and barriers and strategies are not articulated. AREA COVERED For this narrative review, published studies were retrieved from PubMed between January 2000 and December 2020. Search terms included "patient safety," "medication safety," "collaboration," "primary care physician," and "community pharmacy." Resulting articles were categorized as follows: defining collaboration, types of collaboration, and barriers and solutions to collaboration. EXPERT OPINION It is important to understand the factors within a community pharmacy setting that limit or facilitate community pharmacists' participation in medication safety activities. Strategies such as medication review are a common form of collaboration. Barriers to collaboration include misconceptions regarding roles and differences in access to clinical information and community pharmacy practice variability. Future recommendations include increasing training and utilization of pharmacists/PCP teams, increasing community pharmacists' practice in emerging roles, and expanding the community pharmacist role in transitions of care from the hospital to the community.
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Affiliation(s)
- Annesha White
- Department of Pharmacotherapy, University of North Texas Health Science Center College of Pharmacy, Fort Worth, TX, USA
| | - Kimberly G. Fulda
- University of North Texas Health Science Center, Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network (NorTex), Texas College of Osteopathic Medicine, Fort Worth, TX, USA
| | - Rachel Blythe
- Department of Pharmacotherapy, University of North Texas Health Science Center College of Pharmacy, Fort Worth, TX, USA
| | - Michelle A. Chui
- Social and Administrative Sciences Division, University of Wisconsin – Madison School of Pharmacy, Madison, WI, USA
| | - Emily Reeve
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia,Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Richard Young
- JPS Hospital, Department of Family Medicine, Residency Program, Fort Worth, TX, USA
| | - Anna Espinoza
- University of North Texas Health Science Center, Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network (NorTex), Texas College of Osteopathic Medicine, Fort Worth, TX, USA
| | - Noah Hendrix
- University of Texas at Arlington, Arlington, TX, USA
| | - Yan Xiao
- University of Texas at Arlington, Arlington, TX, USA
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Sanchez-Molina AI, Benrimoj SI, Ferri-Garcia R, Martinez-Martinez F, Gastelurrutia MA, Garcia-Cardenas V. Development and validation of a tool to measure collaborative practice between community pharmacists and physicians from the perspective of community pharmacists: the professional collaborative practice tool. BMC Health Serv Res 2022; 22:649. [PMID: 35568892 PMCID: PMC9107731 DOI: 10.1186/s12913-022-08027-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Collaborative practice between community pharmacists and physicians is becoming increasingly common. Although tools and models to explore collaborative practice between both health care professionals have been developed, very few have been validated for their use in clinical practice. The objective of this study was to develop and validate a tool for measuring collaborative practice between community pharmacists and physicians from the perspective of community pharmacists. METHODS The DeVellis method was used to develop and validate the Professional Collaborative Practice Tool. A pool of 40 items with Likert frequency scales was generated based on previous literature and expert opinion. This study was undertaken in Spain. A sample of community pharmacists providing medication reviews with follow-up and a random sample of pharmacists providing usual care were invited to participate. Exploratory and confirmatory factor analysis was used to assess the tool's reliability and content validity. RESULTS Three hundred thirty-six pharmacists were invited with an overall response rate of 84.8%. The initial 40 items selected were reduced to 14 items. Exploratory Factor Analysis provided a 3-factor solution explaining 62% of the variance. Confirmatory Factor Analysis confirmed the three factors "Activation for collaborative professional practice," the "Integration in collaborative professional practice," and the "Professional acceptance in collaborative professional practice." The tool demonstrated an adequate fit (X2/df = 1.657, GFI = 0.889 and RMSEA = 0.069) and good internal consistency (Cronbach's alpha = 0.924). CONCLUSIONS The Professional Collaborative Practice Tool has shown good internal reliability and criterion validity. The tool could be used to measure the perceived level of collaborative practice between community pharmacists and physicians and monitor changes over time. Its applicability and transferability to other settings should be evaluated.
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Affiliation(s)
| | - Shalom I Benrimoj
- Pharmaceutical Care Research Group, University of Granada, Granada, Spain
| | - Ramon Ferri-Garcia
- Department of Statistics and Operations Research, University of Granada, Granada, Spain
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Gemmechu WD, Eticha EM. Factors influencing the degree of physician-pharmacists collaboration within governmental hospitals of Jigjiga Town, Somali National Regional State, Ethiopia, 2020. BMC Health Serv Res 2021; 21:1269. [PMID: 34819071 PMCID: PMC8611947 DOI: 10.1186/s12913-021-07301-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Collaboration is the way to deliver the desired health outcome for the patients or service users in the healthcare. Inter-professional collaboration can improve medication safety, patient outcome and minimize healthcare costs. This study aimed to explore the degree of collaboration and factors influencing collaboration between physicians and pharmacists within the public hospitals of Jigjiga town, Somali National Regional State, Ethiopia, 2020. METHODS A cross-sectional study qualitative was conducted among 149 participants in the two governmental hospitals of the Jigjiga town with a response rate of 79.87%. The collaborative working relationship model and the physician-pharmacist collaborative instrument with three main exchange domains (trustworthiness, role specification, and relationship initiation) and collaborative care items were used. An independent sample t-test was used to compute the differences of the mean scores of physician-pharmacist collaborative instrument domains and collaborative care. Separate multiple regression was employed to assess factors influencing collaborative care for pharmacists and physicians. RESULTS This study showed that pharmacists reported higher mean of collaborative care (10.66 ± 4.75) than physicians (9.17 ± 3.92). The multiple regression indicated that area of practice influence both professionals' collaborative practice. A significant association between collaborative care and the two PPCI domains (trustworthiness and relationship initiation for the physicians; role specification and relationship initiation for pharmacists) was established. CONCLUSIONS The study showed that the collaboration between the physicians and pharmacists was sub-optimal and the exchange variables had a significant influence on their collaboration. RECOMMENDATION Physicians and pharmacists need to exert more efforts to enhance this collaboration. Further qualitative study might be needed to search for factors affecting, barriers and how to develop collaborative practice.
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Affiliation(s)
- Workineh Diriba Gemmechu
- College of Medicine and Health Science, School of Medicine, Jigjiga University, Jigjiga, Ethiopia
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Lukey R, Gray B, Morris C. 'We're just seen as people that give out the methadone…': exploring the role of community pharmacists in the opioid substitution treatment team. J Prim Health Care 2021; 12:358-367. [PMID: 33349324 DOI: 10.1071/hc20108] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/07/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION People receiving opioid substitution treatment are a vulnerable population who experience significant health inequities and stigma, but have regular interactions with community pharmacists. Many pharmacists now work collaboratively with other health providers to ensure effective and safe use of medicines, as well as being involved in the prevention and management of chronic health conditions. AIM To explore the role of New Zealand community pharmacists in the provision of opioid substitution treatment and how they perceive their role as part of the wider opioid substitution treatment team. METHODS Semi-structured video interviews with a purposive sample of 13 diverse pharmacists explored their current practices in providing opioid substitution treatment, and their perceived role in the treatment team. Interviews were audio-recorded and transcribed verbatim. Data were coded and analysed using an inductive thematic approach. RESULTS This study found that pharmacists are providing accessible support to a population with known barriers to accessing health care. However, participants also identified challenges with communication and a perceived lack of understanding of the pharmacist role as barriers to collaboration with the wider opioid substitution treatment team. DISCUSSION Collaboration within health-care teams has been shown to improve health outcomes, and pharmacists are well placed to provide health-care services as well as offer valuable insight into clients' mental and physical wellbeing. Improved communication channels that facilitate information sharing, as well as the opioid substitution treatment team's recognition of a pharmacist's role, may facilitate collaboration and, in turn, improve the quality of health care provided to this vulnerable population.
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Affiliation(s)
- Rebecca Lukey
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand; and Corresponding author.
| | - Ben Gray
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
| | - Caroline Morris
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
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Zielińska-Tomczak Ł, Cerbin-Koczorowska M, Przymuszała P, Marciniak R. How to effectively promote interprofessional collaboration? - a qualitative study on physicians' and pharmacists' perspectives driven by the theory of planned behavior. BMC Health Serv Res 2021; 21:903. [PMID: 34474676 PMCID: PMC8414767 DOI: 10.1186/s12913-021-06903-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/17/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Ajzen's theory of planned behavior (TPB) postulates that individuals' behavioral intention is influenced by their attitudes, subjective norms, and perceived behavioral control. Therefore, it can be used to broaden the understanding of particular behaviors, including healthcare workers' professional activities. METHODS In this study, we used TPB as a theoretical framework to evaluate semi-structured interviews with pharmacists and physicians to build an understanding of the interprofessional collaboration between them. Sixteen semi-structured interviews were conducted with pharmacists and eleven with physicians. The sample of participants comprised a diverse group with varying work experience and workplaces. Data were analyzed independently by two researchers following the thematic analysis method using ATLAS.ti software. Data saturation was set in the absence of new issues arising during the interviews. RESULTS The content analysis allowed for the determination of six main themes: the relationship between previous experiences and attitudes towards collaboration, pharmacist's role in collaboration, mutual reluctance toward collaboration, the role of decision- and policy-makers, knowledge and qualifications gaps regarding collaboration, and lack of organizational paths. CONCLUSIONS Despite both physicians and pharmacists displaying positive attitudes towards collaboration may foster their intention to establish a professional partnership, subjective norms (e.g., the lack of appropriate legal regulations) and perceived behavioral control (physicians' lack of awareness about pharmacists' qualifications and the low level of interpersonal skills) might impede the process.
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Affiliation(s)
- Łucja Zielińska-Tomczak
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, 60-806, Poznan, Poland.
| | - Magdalena Cerbin-Koczorowska
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, 60-806, Poznan, Poland
| | - Piotr Przymuszała
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, 60-806, Poznan, Poland
| | - Ryszard Marciniak
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, 60-806, Poznan, Poland
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Miller MJ, Pammett RT. A scoping review of research on Canadian team-based primary care pharmacists. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:106-115. [PMID: 33729533 DOI: 10.1093/ijpp/riaa021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022]
Abstract
OBJECTIVES An ageing population with an increasing prevalence of chronic disease and complex medication regimens has placed a strain on healthcare systems in Canada. A limited number of team-based primary care pharmacists are integrated into primary care clinics across the country, working alongside other members of the health care team to identify and resolve drug therapy problems and improve outcomes. While many studies have been completed in the area, the extent of research on integrated team-based primary care pharmacists in Canada is unknown. The objectives of this work were to describe the literature that exists surrounding pharmacists in a primary health care team setting in Canada. A scoping review of research focusing on pharmacists in team-based primary health care settings in Canada was performed. Thematic analysis was then performed to categorize the identified studies. KEY FINDINGS The search identified 874 articles, of which 93 met inclusion criteria relevant to the objective. From these 93 studies, 4 themes and 23 subthemes were identified, with some studies having more than one theme or subtheme. Themes identified were the following: primary care pharmacist scope of practice (n = 79 studies), collaboration/communication within the primary care setting (n = 26), chronic disease management (n = 24) and 'other' (n = 15). SUMMARY This research quantified and categorized 93 studies on pharmacists in interprofessional primary care teams in Canada. As this is an expanding role for pharmacists in Canada, understanding the current state of the literature is an important consideration when developing future team-based primary care roles.
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Affiliation(s)
| | - Robert T Pammett
- Northern Health Authority, Prince George, British Columbia, Canada
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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Kennelty KA, Engblom NJ, Carter BL, Hollingworth L, Levy BT, Finkelstein RJ, Parker CP, Xu Y, Jackson KL, Dawson JD, Dorsey KK. Dissemination of a telehealth cardiovascular risk service: The CVRS live protocol. Contemp Clin Trials 2021; 102:106282. [PMID: 33444781 DOI: 10.1016/j.cct.2021.106282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Medical clinics are increasingly hiring clinical pharmacists to improve management of cardiovascular disease (CVD). However, the limited number of clinical pharmacists employed in a clinic may not impact the large number of complex patients needing the services. We have developed a remote telehealth service provided by clinical pharmacists to complement CVD services provided by on-site clinical pharmacists and aid sites without a clinical pharmacist. This cardiovascular risk service (CVRS) has been studied in two NIH-funded trials, however, we identified barriers to optimal intervention implementation. The purpose of this study is to examine how to implement the CVRS into medical offices and see if the intervention will be sustained. METHODS This is a 5-year, pragmatic, cluster-randomized clinical trial in 13 primary care clinics across the US. We randomized clinics to receive CVRS or usual care and will enroll 325 patient subjects and 288 key stakeholder subjects. We have obtained access to the electronic medical records (EMRs) of all study clinics to recruit subjects and provide the pharmacist intervention. The intervention is staggered so that after 12 months, the usual care sites will receive the intervention for 12 months. Follow-up will be accomplished though medical record abstraction at baseline, 12 months, 24 months, and 36 months. CONCLUSIONS This study will enroll subjects through 2021 and results will be available in 2024. This study will provide unique information on how the CVRS provided by remote clinical pharmacists can be effectively implemented in medical offices, many of which already employ on-site clinical pharmacists. CLINICAL TRIAL REGISTRATION INFORMATION NCT03660631: http://clinicaltrials.gov/ct2/show/NCT03660631.
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Affiliation(s)
- Korey A Kennelty
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, United States; Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States.
| | - Nels J Engblom
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, United States
| | - Barry L Carter
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, United States; Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States
| | - Liz Hollingworth
- Department of Educational Policy and Leadership Studies, College of Education, University of Iowa, United States
| | - Barcey T Levy
- Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States; Department of Epidemiology, College of Public Health, University of Iowa, United States
| | - Rachel J Finkelstein
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, United States
| | - Christopher P Parker
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, United States
| | - Yinghui Xu
- Department of Family Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, United States
| | - Kayla L Jackson
- Department of Educational Policy and Leadership Studies, College of Education, University of Iowa, United States
| | - Jeffrey D Dawson
- Department of Biostatistics, College of Public Health, University of Iowa, United States
| | - Kathryn K Dorsey
- Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa, United States
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Hashmi F, Hassali MA, Saleem F, Saeed H, Islam M, Malik UR, Atif N, Babar ZUD. Perspectives of community pharmacists in Pakistan about practice change and implementation of extended pharmacy services: a mixed method study. Int J Clin Pharm 2021; 43:1090-1100. [PMID: 33411180 DOI: 10.1007/s11096-020-01221-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
Background Community pharmacists' role in the primary health care, patient-centered services, beyond traditional dispensing services is well established in the developed world. However, this role is not fully established in low-middle-income countries including Pakistan. Objective To explore community pharmacists' perspectives and preparedness about practice change and associated facilitators and barriers to extended services. Setting A study was conducted involving community pharmacists of Lahore, Pakistan. Method Two phased studies were conducted using mixed-method sequential design. The first phase involved qualitative semi-structured face-to-face interviews with the community pharmacists, while the second phase constituted a questionnaire-based cross-sectional study. Main outcome measure Pharmacists' perspectives about extended pharmacy services, facilitators, barriers and preparedness for the practice change. Results For the first phase, pharmacists were purposively sampled and the saturation yielded a final sample size of fifteen pharmacists (N = 15). The thematic content analysis yielded four distinct themes; (1) current practices and familiarity with extended pharmacy services (2) practice gap between Pakistan and the developed countries (3) facilitators and the preparedness, and (4) barriers towards its implementation and provision. The second part was a questionnaire-based cross-sectional phase, where a total of 348 community pharmacists were approached, while only 242 responded, yielding a response rate of 69.5%. The triangulation of qualitative and quantitative data identified several barriers such as; shortage of pharmacists, lack of knowledge and skills, poor collaboration with general practitioners, failure of customers to pay for extended services. Facilitators and preparedness for the provision of extended pharmacy services were; access to patient notes, follow-up, separate counselling areas, accreditation of specific services and sufficient resources. Conclusion This study's findings call for the implementation and enforcement of Punjab Drug Sale Rules 2007 to facilitate the practice change and provision of comprehensive pharmacy services in Punjab, Pakistan. There is a need for additional laws to define community pharmacists' roles, uniform job description, training, new funding model, separate area, and accreditation of extended pharmacy services in Pakistan.
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Affiliation(s)
- Furqan Hashmi
- University College of Pharmacy, University of the Punjab Allama Iqbal Campus, Lahore, Pakistan.
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden, Pulau Penang, Malaysia
| | - Fahad Saleem
- Faculty of Pharmacy, University of Balochistan, Sariab Road, Quetta, Pakistan
| | - Hamid Saeed
- University College of Pharmacy, University of the Punjab Allama Iqbal Campus, Lahore, Pakistan
| | - Muhammad Islam
- University College of Pharmacy, University of the Punjab Allama Iqbal Campus, Lahore, Pakistan
| | | | - Naveel Atif
- School of Pharmacy, Xi'an Jiaotong University, Xi'an, China
| | - Zaheer-Ud-Din Babar
- Department of Pharmacy, University of Huddersfield, Huddersfield, HD1 3DH, UK
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Kitahara K, Uchikura T, Nio Y, Katsuragi S, Okazaki K, Nishi Y, Kawaguchi T, Yamaguchi T, Sasaki T. Developing a Japanese version of the 'scale of attitudes toward pharmacist-physician collaboration'. J Interprof Care 2020; 35:920-926. [PMID: 33190562 DOI: 10.1080/13561820.2020.1834369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
There are many reports that pharmacotherapy has been optimized to ensure collaboration between physicians and pharmacists. Various scales assess the relationship between physicians and pharmacists as well as medical students and pharmacy students. The Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP2C) can be applied not only to the physician-pharmacist relationship but also to the medical-pharmacy student relationship. As there is no Japanese version of the SATP2C, we developed one and examined its psychometric properties. SATP2C scores were measured before and after interprofessional education (IPE) to verify responsiveness. The scale showed confirmed reliability: Cronbach's alphas were 0.79 for Responsibility and Accountability, 0.68 for Shared Authority, and 0.67 for Interdisciplinary Education. Pre and post-IPE, each mean subscale score increased: Responsibility and Accountability, 0.7 ± 0.4; Shared Authority, 0.2 ± 0.3; and Interdisciplinary Education, 0.3 ± 0.2. Although the total score increased (1.2 ± 0.7), this was non-significant. The Japanese version of the SATP2C can be considered, at least initially, to have reached an acceptable level of reliability and validity. The new measure is currently the only scale in Japan that can evaluate attitudes toward physician-pharmacist collaboration regarding IPE. Further studies are needed to confirm responsiveness pre- and post-IPE.
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Affiliation(s)
- Kanayuki Kitahara
- Department of Hospital Pharmaceutics, Showa University School of Pharmacy, Tokyo, Japan
| | - Takeshi Uchikura
- Department of Hospital Pharmaceutics, Showa University School of Pharmacy, Tokyo, Japan
| | - Yuta Nio
- Department of Hospital Pharmaceutics, Showa University School of Pharmacy, Tokyo, Japan
| | - Satoko Katsuragi
- Department of Hospital Pharmaceutics, Showa University School of Pharmacy, Tokyo, Japan
| | - Keinosuke Okazaki
- Department of Hospital Pharmaceutics, Showa University School of Pharmacy, Tokyo, Japan
| | - Yoshiko Nishi
- Department of Pharmacy, Kanazawa Medical University Hospital, Ishikawa, Japan
| | - Takashi Kawaguchi
- Department of Practical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Tadanori Sasaki
- Department of Hospital Pharmaceutics, Showa University School of Pharmacy, Tokyo, Japan
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Walraven B, Ponjee G, Heideman W, Çarkit FK. Medication reviews in hospitalized patients: a qualitative study on perceptions of primary and secondary care providers on interprofessional collaboration. BMC Health Serv Res 2020; 20:902. [PMID: 32993650 PMCID: PMC7526422 DOI: 10.1186/s12913-020-05744-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 09/17/2020] [Indexed: 12/22/2022] Open
Abstract
Background In-hospital medication reviews are regularly performed. However, discontinuity in care could occur because secondary care providers lack insight into the outpatient history. Furthermore, for the implementation or follow-up of some medication review-based interventions, the help of primary care providers is essential. This requires interprofessional collaboration between secondary and primary care. Therefore, the aim of this qualitative study was to gain insight into the perceptions of primary and secondary care providers on interprofessional collaboration on medication reviews in hospitalised patients. Methods Ten face-to-face semi-structured interviews and three focus group discussions were conducted with 20 healthcare providers from three hospitals and community health services. The interviews were aimed at exploring general practitioners’, community pharmacists’, geriatricians’, and hospital pharmacists’ experiences, attitudes, and views of interprofessional collaboration. Focus groups consisted of representatives of all professional groups. Through group discussion, interprofessional collaboration was explored by addressing three main questions: 1) What are the benefits of in-hospital medication reviews? 2) What are the barriers to in-hospital medication reviews from an interprofessional collaboration perspective? 3) Given the barriers mentioned, how should this interprofessional collaboration between primary and secondary care be designed? Data were analysed using a thematic-content approach. Results The need for in-hospital medication reviews was underlined due to their many benefits, such as reducing potentially preventable re-admissions. Barriers regarding interprofessional collaboration between primary and secondary care can be subdivided into three main themes: 1) defining in-hospital medication reviews (e.g., lack of clear goals), 2) execution of medication reviews (e.g., hospital setting is dynamic), and 3) follow-up after discharge (e.g., unclear instructions). Care providers suggested solutions for each of the barriers mentioned, for example, by using supportive staff in order to overcome the gap between primary and secondary care providers and making clear agreements on proper means of communication. Conclusion Primary and secondary care providers recognise the importance of in-hospital medication reviews and the need for interprofessional collaboration. To create satisfying interprofessional collaboration, conditions should be met on defining in-hospital medication reviews across settings and involving both primary and secondary care providers in implementing medication reviews and organising their follow-up.
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Affiliation(s)
- Bregje Walraven
- Department of Clinical Pharmacy, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands.,Present address: Department of Psychiatry, GGZ in Geest, Haarlem, the Netherlands
| | - Godelieve Ponjee
- Department of Clinical Pharmacy, Amsterdam UMC location AMC, Amsterdam, the Netherlands
| | - Wieke Heideman
- Department of Research and Epidemiology, OLVG, Amsterdam, Netherlands
| | - Fatma Karapinar Çarkit
- Department of Clinical Pharmacy, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands.
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Rakvaag H, SØreide GE, Meland E, Kjome RL. Complementing or conflicting? How pharmacists and physicians position the community pharmacist. Pharm Pract (Granada) 2020; 18:2078. [PMID: 33029263 PMCID: PMC7523557 DOI: 10.18549/pharmpract.2020.3.2078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/06/2020] [Indexed: 01/09/2023] Open
Abstract
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.
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Affiliation(s)
- Hilde Rakvaag
- MPharm. Department of Global Public Health and Primary Care, Centre for Pharmacy, University of Bergen. Bergen (Norway).
| | - Gunn E SØreide
- Dr.Phil. Associate Professor. Department of Education, University of Bergen. Bergen (Norway).
| | - Eivind Meland
- MD, PhD. Emeritus Professor. Department of Global Public Health and Primary Care, University of Bergen. Bergen (Norway).
| | - Reidun L Kjome
- MPharm, PhD. Associate Professor. Department of Global Public Health and Primary Care, Centre for Pharmacy, University of Bergen. Bergen (Norway).
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Canaries in the coalmine: Stakeholder perspectives of medication management reviews for residents with dementia. Res Social Adm Pharm 2020; 16:1220-1227. [DOI: 10.1016/j.sapharm.2019.12.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/20/2019] [Accepted: 12/02/2019] [Indexed: 02/06/2023]
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Nasir BB, Gezahegn GT, Muhammed OS. Degree of physician-pharmacist collaboration and influencing factors in a teaching specialized hospital in Ethiopia. J Interprof Care 2020; 35:361-367. [PMID: 32619158 DOI: 10.1080/13561820.2020.1777953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Several studies have found that physician-pharmacist collaboration improves medication therapy outcomes. This study aimed to measure the degree of physician-pharmacist collaboration in Ethiopia, to identify associated factors, and to determine barriers to their collaboration. A cross-sectional study was conducted among 299 health professionals (246 physicians and 53 pharmacists) in Tikur Anbessa Specialized Hospital, Ethiopia. The Collaborative Working Relationship Model and the Physician-Pharmacist Collaborative Instrument (PPCI) with three main exchange characteristics (trustworthiness, role specification, and relationship initiation), and collaborative care items were used. Barriers to collaboration and areas that need further collaboration were assessed. Multiple regression was used to assess influencing factors. This study revealed that, in Ethiopia, physicians had higher PPCI mean scores on collaborative care items (4.22 ± 1.35) compared to pharmacists (3.25 ± 0.86). Areas of practice and relationship initiation were the two influencing factors for collaboration among pharmacists. But for physicians, age, areas of practice, educational qualification, role specification, and trustworthiness were the factors associated with collaboration. Lack of face-to-face communication and fragmentation of care were the common barriers. However, the vast majority of members of both professions believed that collaboration should be developed in their future practice. Their current collaboration seems suboptimal, and exchange characteristics, which reflect interactions between the practitioners, had a significant influence on their collaboration in addition to other factors.
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Affiliation(s)
- Beshir Bedru Nasir
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getahun Tigistie Gezahegn
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Oumer Sada Muhammed
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Bankes DL, Schamp RO, Knowlton CH, Bain KT. Prescriber-Initiated Engagement of Pharmacists for Information and Intervention in Programs of All-Inclusive Care for the Elderly. PHARMACY 2020; 8:pharmacy8010024. [PMID: 32098064 PMCID: PMC7151697 DOI: 10.3390/pharmacy8010024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 02/13/2020] [Accepted: 02/18/2020] [Indexed: 02/08/2023] Open
Abstract
Little is known about the types of drug information inquiries (DIIs) prescribers caring for older adults ask pharmacists during routine practice. The objective of this research was to analyze the types of DIIs prescribing clinicians of Programs of All-Inclusive Care for the Elderly (PACE) made to clinical pharmacists during routine patient care. This was a retrospective analysis of documented pharmacists' encounters with PACE prescribers between March through December, 2018. DIIs were classified using a developed taxonomy that describes prescribers' motivations for consulting with pharmacists and their drug information needs. Prescribers made 414 DIIs during the study period. Medication safety concerns motivated the majority of prescribers' inquiries (223, 53.9%). Inquiries received frequently involved modifying drug therapy (94, 22.7%), identifying or resolving adverse drug events (75, 18.1%), selecting or adjusting doses (61, 14.7%), selecting new drug therapies (57, 13.8%), and identifying or resolving drug interactions (52, 12.6%). Central nervous system medications (e.g., antidepressants and opioids), were involved in 38.6% (n = 160) of all DIIs. When answering DIIs, pharmacists made 389 recommendations. Start alternative medications (18.0%), start new medications (16.7%), and change doses (12.1%) were the most frequent recommendations rendered. Prescribers implemented at least 79.3% (n = 268) of recommendations based on pharmacy records (n = 338 verifiable recommendations). During clinical practice, PACE prescribers commonly ask pharmacists a variety of DIIs, largely related to medication safety concerns. In response to these DIIs, pharmacists provide medication management recommendations, which are largely implemented by prescribers.
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Boylan PM, Sedlacek J, Santibañez M, Church AF, Lounsbury N, Nguyen J. Development and Implementation of Interprofessional Relations Between a College of Pharmacy and Osteopathic Residency Programs in a Community Teaching Hospital. J Pharm Technol 2020; 36:3-9. [PMID: 34752515 PMCID: PMC6931159 DOI: 10.1177/8755122519865540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024] Open
Abstract
Background: Team-based health care optimizes patient outcomes, and therefore, both interprofessional education (IPE) and interprofessional relations (IPR) are required in health professions education, postgraduate training, and real-world clinical practice. Existing literature describes progressive developments and assessments of IPE in colleges of pharmacy and medicine; however, there are fewer reports describing processes or projects that foster physician-pharmacist IPR in clinical practices without established interprofessional collaborations. Objectives: The primary objective was to establish IPR between pharmacists and osteopathic residents in a community teaching hospital. The secondary objective was to innovate the delivery of pharmacotherapeutic content delivered to the residents during their didactic lecture series by providing active learning strategies. Methods: This report describes a project wherein college of pharmacy faculty developed IPR with osteopathic residents in a community teaching hospital that previously did not have any established physician-pharmacist IPR. Osteopathic medical residents completed a post-implementation survey after they attended a 12-month series of didactic lectures that incorporated active learning delivered by pharmacist faculty. Results: Sixty-six residents were eligible to complete the survey; 20 residents completed the survey. Eighteen residents believed that both physicians and pharmacists should be educated to establish IPR and that it should be included in professional, graduate, and continuing education settings for both professions. Sixteen residents believed that the active learning techniques employed by college of pharmacy faculty were useful for IPR. Conclusions: Physician-pharmacist IPR may be achievable in settings where IPR was previously sparse. Shared interests, adherence, and innovations in IPR frameworks are essential for developing physician-pharmacist IPR.
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Hohmeier KC, Garst A, Adkins L, Yu X, Desselle SP, Cost M. The Optimizing Care Model: A novel community pharmacy approach to enhance patient care delivery by leveraging the technician workforce through technician product verification. J Am Pharm Assoc (2003) 2019; 59:880-885. [DOI: 10.1016/j.japh.2019.07.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 06/12/2019] [Accepted: 07/16/2019] [Indexed: 11/17/2022]
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28
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Ventricelli DJ, Mathis SM, Foster KN, Pack RP, Tudiver F, Hagemeier NE. Communication Experiences of DATA-Waivered Physicians with Community Pharmacists: A Qualitative Study. Subst Use Misuse 2019; 55:349-357. [PMID: 31591924 PMCID: PMC7002186 DOI: 10.1080/10826084.2019.1670210] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: Patients engaged in evidence-based opioid use disorder (OUD) treatment can obtain prescriptions for buprenorphine containing products from specially trained physicians that are subsequently dispensed by community pharmacists. Despite the involvement of physicians and community pharmacists in buprenorphine prescribing and dispensing, respectively, our understanding of their interactions in this context is limited. Objective: To qualitatively describe the communication and collaborative experiences between Drug Addiction Treatment Act 2000 (DATA)-waivered physicians and community pharmacists from the perspective of the physician. Methods: Ten key informant interviews were conducted with DATA-waivered physicians practicing in Northeast Tennessee. A semi-structured interview guide was used to explore communication and collaborative experiences between the physicians and community pharmacists. Interviews were audio recorded and transcribed verbatim. A coding frame was developed using concepts from the scientific literature and emerging codes from physician interviews. Interviews were coded using NVivo 11, with the data subsequently organized and evaluated for themes. Results: Four themes were identified: (1) mechanics of communication; (2) role specification and expectations; (3) education and understanding; and (4) climate of clinical practice. Physician-pharmacist communication primarily occurred indirectly through patients or staff and perceived challenges to collaboration included; lack of trust, stigma, and fear of regulatory oversight. Physicians also indicated the two professionals may lack clear roles and responsibilities as well as common expectations for treatment plans. Conclusions: Communication between DATA-waivered physicians and community pharmacists is influenced by multiple factors. Further research is warranted to improve physician-community pharmacist collaboration (PCPC) in the context of OUD pharmacotherapy and addiction treatment.
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Affiliation(s)
- Daniel J. Ventricelli
- Department of Pharmacy Practice and Administration,
Philadelphia College of Pharmacy, University of the Sciences, 600 S. 43rd Street,
Philadelphia, PA 19104-4495, USA
| | - Stephanie M. Mathis
- Center for Prescription Drug Abuse Prevention and
Treatment, East Tennessee State University, College of Public Health 104 Lamb Hall,
P.O. Box 70623 Johnson City, TN 37614, USA
| | - Kelly N. Foster
- Department of Sociology & Anthropology, East Tennessee
State University, 223 Rogers-Stout Hall P.O. Box 70644 Johnson City, TN 37614-1702
USA
| | - Robert P. Pack
- Department of Community and Behavioral Health, East
Tennessee State University College of Public Health 104 Lamb Hall, P.O. Box 70623
Johnson City, TN 37614, USA
| | - Fred Tudiver
- Department of Family Medicine, East Tennessee State
University Quillen College of Medicine, P.O. Box 70300 Johnson City, TN 37614
USA
| | - Nicholas E. Hagemeier
- Department of Pharmacy Practice, East Tennessee State
University Gatton College of Pharmacy, P.O. Box 70657, Johnson City, TN 37614,
USA
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29
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Kibicho J, Dilworth T, Owczarzak J, Ndakuya F. Pharmacist-initiated adherence promotion activities for persons living with HIV in ambulatory care settings: Instrument development and initial psychometric testing. Res Social Adm Pharm 2019; 16:921-927. [PMID: 31636008 DOI: 10.1016/j.sapharm.2019.09.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 08/19/2019] [Accepted: 09/26/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Consistent adherence to antiretroviral therapy (ART) remains a challenge for half the people living with HIV (PLWH) in the U.S. Pharmacists have the expertise in pharmacology and pharmacotherapeutics to manage ART and optimize PLWH outcomes. We developed and validated the psychometric properties of a scale to measure the breadth and depth of adherence promotion activities provided by pharmacists to PLWH in ambulatory care settings. METHODS An initial 37-item instrument was developed from 31 pharmacists' interviews and a comprehensive literature review. Psychometric properties were assessed from responses to questionnaires of 10 content experts and 184 ambulatory pharmacists in 37 States. Psychometric tests included: content validity index (CVI); Exploratory Factor Analysis (EFA); and internal reliability using Cronbach's alpha (α). RESULTS 26 items were eliminated in the item reduction stage. The final 11-item adherence promotion activities scale (APAS) was a single factor with high loadings (0.51-0.85), good internal consistency (α ≤ 0.93) and an explained variance of 60%. For known-groups validity, HIV-certified pharmacists had comparatively higher and statistically significant APAS score compared to non-certified pharmacists (4.00, p < .001). CONCLUSIONS Preliminary psychometric testing-factor analysis, and high internal consistency-depict that APAS can be useful in scientific research and pharmacy practice to assess the nature and range of pharmacists' above-and-beyond prescription services in real-world ambulatory settings. Further validation work is needed to establish conclusive reliability and validity of the newly developed scale.
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Affiliation(s)
- Jennifer Kibicho
- College of Nursing, University of Wisconsin-Milwaukee, P O Box 413, Milwaukee, WI, USA.
| | - Thomas Dilworth
- Department of Pharmacy Services, Aurora St. Luke's Medical Center, Milwaukee, WI, USA
| | - Jill Owczarzak
- Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA
| | - Florine Ndakuya
- College of Nursing, University of Wisconsin-Milwaukee, P O Box 413, Milwaukee, WI, USA
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30
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Planas LG, Desselle SP, Cao K. Valuable Lessons for Pharmacist PBRNs: Insights and Experiences from Physician PBRN Members. PHARMACY 2019; 7:E123. [PMID: 31461922 PMCID: PMC6789583 DOI: 10.3390/pharmacy7030123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 08/21/2019] [Accepted: 08/23/2019] [Indexed: 11/26/2022] Open
Abstract
Practice-based research networks (PBRNs) rely on a cadre of engaged members to participate in research projects. As pharmacist PBRNs increase in number, it is helpful to understand how members of other professions view their own participation in PBRNs and potential collaborative research endeavors with pharmacists. Due to their longer history of PBRN experience, physician PBRN members may have helpful advice for the establishment of pharmacy networks. The objectives of this study were to describe perceptions among a group of physician PBRN members about: Advice for developing a pharmacist PBRN, practice aspects that might benefit from collaborating with pharmacists who are part of a PBRN, and benefits and challenges of PBRN member participation. This study employed qualitative research methods. Semi-structured interviews were conducted with physician members of the Oklahoma Physicians Resource/Research Network, a primary care PBRN. Advice for establishing a pharmacist PBRN included identifying a champion, recruiting a core group, and conducting a needs assessment. Collaborative areas of interest included medication use management, patient education on chronic disease states, and physician education on new therapies. Participation benefits were categorized as personal satisfaction, improvement in practice quality improvement, advancement of specialty, peer interaction and learning, and real-time information and support. These findings offer insight into strategies for developing and sustaining pharmacist PBRNs and may inform pharmacist PBRN initiatives related to development, member recruitment and retention, and interprofessional project planning with physician PBRNs.
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Affiliation(s)
- Lourdes G Planas
- Department of Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA.
| | - Shane P Desselle
- Department of Social, Behavioral and Administrative Sciences, California College of Pharmacy, Touro University, Vallejo, CA 94952, USA
| | - Kaitlyn Cao
- Walgreens, Irving, TX 75063, USA
- College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117, USA
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Crnjanski T, Krajnovic D, Savic M. Pharmacists' Assessment of the Difficulty and Frequency of Ethical Issues Encountered in Community Pharmacy Settings. SCIENCE AND ENGINEERING ETHICS 2019; 25:1017-1036. [PMID: 28536752 DOI: 10.1007/s11948-017-9870-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 01/02/2017] [Indexed: 06/07/2023]
Abstract
Researching ethical problems and their frequency could give us a complex picture and greater insight into the types of ethical issues that pharmacists face in providing health care. The overall aim of this study was to assess the pharmacist's perception of difficulty and frequency of selected ethical issues encountered by the community pharmacists in their everyday practice. A quantitative cross sectional multicenter study was performed using a validated survey instrument - Ethical Issue Scale for Community Pharmacy (EISP). The results of the analysis of 690 completely filled out instruments (response rate 78.49%) showed the difference between the ethical issues which always occurred ("A pharmacist is prevented from dispensing a medicine to the patient due to an administrative error in the prescription"), and the ones that pharmacists found most difficult ("A pharmacist dispenses a medicine he/she personally considers inadequate for the therapeutic treatment of the patient, in order to avoid any conflicts with the physician" and "A pharmacist is considering violating the rules and regulations in order to perform an act of humanity"). The majority of respondents (84.78%) were familiar with the Code of Ethics but the correlation between the familiarity and the perceived usefulness of the code in resolving problems in everyday practice was negative (ρ = -0.17, p < 0.001). Results showed that patients' well-being had a high influence on pharmacists' behavior. The results provided quantitative data by the examination of specific ethical issues and their occurrence. Further empirical research is recommended in order to systematically identify the ethical issues faced by community pharmacists.
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Affiliation(s)
| | - Dusanka Krajnovic
- Department of Social Pharmacy and Pharmaceutical Legislation, The Center for the Study of Bioethics, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Mirko Savic
- Department of Business Informatics and Quantitative Methods, Faculty of Economics in Subotica, University of Novi Sad, Novi Sad, Serbia
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Adeoye OA, Farley JF, Coe AB, Pestka DL, Farris KB, Zillich AJ, Snyder ME. Medication Therapy Management Delivery by Community Pharmacists: Insights from a National Sample of Medicare Part D Beneficiaries. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019; 2:373-382. [PMID: 31460497 PMCID: PMC6711192 DOI: 10.1002/jac5.1160] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 06/11/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The Medicare Part D medication therapy management (MTM) program positions pharmacists to optimize beneficiaries' medications and improve care. Little is known regarding Part D MTM delivery by community pharmacists and other pharmacist provider types. OBJECTIVES To (1) characterize Medicare Part D MTM delivery by community pharmacists, (2) compare MTM delivery by community pharmacists to other pharmacists, and (3) generate hypotheses for future research. METHODS A descriptive cross-sectional study using merged data from a 20% random sample of Medicare beneficiary enrollment data with a 100% sample of recently available 2014 Part D MTM files was conducted. Andersen's Behavioral Model was applied to describe MTM delivery across beneficiary characteristics. Descriptive and bivariate statistics were used to compare delivery of MTM between community and other pharmacist providers. RESULTS Among beneficiaries sampled, community pharmacists provided comprehensive medication reviews (CMRs) to 22% (n=26,337) of beneficiaries receiving at least one CMR. Almost half (49.4%) were provided face-to-face. Across pharmacist cohorts, median days to CMR offer of post-MTM program enrollment were within the 60-day policy requirement. The community pharmacist cohort had fewer days from CMR offer to receipt (median 47 days). Community pharmacists provided more medication therapy problem (MTP) recommendations (mean [SD] of 1.8 [3.5]; p<0.001), but resolved less MTPs (0.2 [0.7]; p<0.001), and most commonly served beneficiaries that were in the south but less in the west/northeast. Additionally, community pharmacists served a smaller proportion of black beneficiaries, yet a larger proportion of Hispanic beneficiaries (p<0.001). CONCLUSION Community pharmacists provided approximately one in five CMRs for MTM eligible beneficiaries in 2014, with CMRs occurring more quickly, resulting in more MTP recommendations, but resolving less MTPs than those provided by non-community pharmacists. Future research should explore geographic/racial-ethnic disparities in beneficiaries served and strategies to increase negligible MTP resolution by community pharmacists.
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Affiliation(s)
| | - Joel F Farley
- University of Minnesota College of Pharmacy, Minneapolis, MN
| | | | | | - Karen B Farris
- University of Michigan College of Pharmacy, Ann Arbor, Michigan
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Bollen A, Harrison R, Aslani P, van Haastregt JCM. Factors influencing interprofessional collaboration between community pharmacists and general practitioners-A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:e189-e212. [PMID: 30569475 DOI: 10.1111/hsc.12705] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/20/2018] [Accepted: 11/22/2018] [Indexed: 06/09/2023]
Abstract
Effective interprofessional collaboration is critical for sustaining high quality care in the context of the increasing burden on primary healthcare services. Despite this, there is limited understanding of the factors contributing to effective collaboration between general practitioners and community pharmacists. The aim of this systematic review was to identify the factors that impact on interprofessional collaboration between general practitioners (GPs) and community pharmacists (CPs). Keywords and synonyms were combined and applied to four databases (EMBASE, CINAHL, SCOPUS, and MEDLINE) to identify articles published between January 2000 to April 2017. Relevant journals and reference lists were also hand-searched. A total of 37 articles met the eligibility criteria. Factors that posed a challenge to effective interprofessional collaboration were the perceived imbalance in hierarchy and power between the professions and a lack of understanding of each other's skills and knowledge. Experience of collaboration with the other party led to greater understanding of each other's capabilities and potential role in co-delivering patient care. The physical environment was also identified as important, with co-location and other resources to facilitate clear and regular communication identified as important facilitators of interprofessional collaboration. The review findings highlight a range of approaches that may positively influence interprofessional collaboration between GPs and CPS such as co-location, co-education to understand the professional capabilities of each group, and utilising compatible technologies to facilitate communication between the two professions.
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Affiliation(s)
- Annelies Bollen
- Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Institute, Maastricht University, Maastricht, The Netherlands
- School of Public Health & Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Reema Harrison
- School of Public Health & Community Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Parisa Aslani
- School of Public Health & Community Medicine, University of New South Wales, Sydney, NSW, Australia
- Faculty of Pharmacy, The University of Sydney, Camperdown, NSW, Australia
| | - Jolanda C M van Haastregt
- Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, CAPHRI Care and Public Health Institute, Maastricht University, Maastricht, The Netherlands
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Håkansson Lindqvist M, Gustafsson M, Gallego G. Exploring physicians, nurses and ward-based pharmacists working relationships in a Swedish inpatient setting: a mixed methods study. Int J Clin Pharm 2019; 41:728-733. [PMID: 30937695 PMCID: PMC6554255 DOI: 10.1007/s11096-019-00812-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 03/15/2019] [Indexed: 10/29/2022]
Abstract
Background In Sweden there has been limited work investigating the integration and nature of collaborative relationships between pharmacists and other healthcare practitioners. Objective To explore the working relationships of physicians, nurses and ward-based pharmacists in a rural hospital after the introduction of a clinical pharmacy service. Setting General medical ward in a rural hospital in northern Sweden. Method Mixed methods involving face-to-face semi-structured interviews with nurses, physicians and pharmacists, and a physician survey using the Physician-Pharmacist Collaboration Index to measure the extent of physician-reported collaborative working relationships. Main outcome measure Perceptions about collaborative working relationships between physician, nurses and pharmacists. Results All physicians (n = 9) who interacted with the clinical pharmacists completed the survey. The mean total score was 78.6 ± 4.7, total 92 (higher scores represent a more advanced relationship). Mean domain scores were highest for relationship initiation (13.0 ± 1.3, total 15), and trustworthiness (38.9 ± 3.4, total 42), followed by role specification (26.3 ± 2.6, total 30). The interviews (with nurses and physicians), showed how communication, collaboration and joint knowledge-exchange in the intervention changed and developed over time. Conclusion This study provides new insights into collaborative working relationships from the perspectives of physicians and nurses. The Physician-Pharmacist Collaboration Index scores suggest that physicians felt that clinical pharmacists were active in providing patient care; could be trusted to follow up on recommendations; and were credible. The interviews suggest that the team-based intervention provided good conditions for creating new ways to work to achieve commitment to professional working relationships.
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Affiliation(s)
| | - Maria Gustafsson
- Department of Pharmacology and Clinical Neuroscience, Umeå University, 90187, Umeå, Sweden
| | - Gisselle Gallego
- Department of Pharmacology and Clinical Neuroscience, Umeå University, 90187, Umeå, Sweden
- School of Medicine, The University of Notre Dame Australia, Sydney, NSW, Australia
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Weissenborn M, Krass I, Van C, Dähne A, Ritter CA, Haefeli WE, Seidling HM. Process of translation and cross-cultural adaptation of two Australian instruments to evaluate the physician-pharmacist collaboration in Germany. Res Social Adm Pharm 2019; 16:74-83. [PMID: 31122799 DOI: 10.1016/j.sapharm.2019.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Building interprofessional working relationships between physicians and pharmacists is essential to ensure high-quality patient care. To assess which factors influence the performance and success of their collaboration, validated instruments should be used, such as the Australian "Attitudes Toward Collaboration Instrument (ATCI)" and the "Frequency of Interprofessional Collaboration Instrument (FICI)". Both instruments were already translated in a previous German study, but not pretested for comprehensibility or cultural appropriateness to ensure that the target group is able to adequately answer the translated items. OBJECTIVES To translate and particularly cross-culturally adapt two Australian instruments measuring physicians' and pharmacists' attitudes towards interprofessional collaboration and the frequency of their interactions for use in Germany. METHODS The ATCI and FICI were translated following internationally recognised guidelines. Two-step cognitive interviewing was performed with physicians and pharmacists working in ambulatory care in Germany. The "Standards for Reporting Qualitative Research" were used to report this study. RESULTS Overall, 2 forward and 2 back translations, and 38 cognitive interviews, i.e. cognitive probing (N = 10) and behaviour observation (N = 28), with 18 physicians and 20 pharmacists were performed. Experts discussed all potential changes. The ATCI and FICI were translated introducing 15 minor (e.g. paraphrasing, item order) and 6 major (e.g. 2 more items in FICI, additional response options) adaptations. The ATCI-P/GP-German and FICI-P/GP-German were found to be easy to answer and clearly-phrased. CONCLUSION This study shows the importance of using recognised methods to translate and adapt questionnaires, consisting of at least four steps: forward translation, back translation, cognitive interviewing and finalisation (each reviewed by an expert panel making their decisions by consensus). A profoundly pretested German-speaking instrument is now available to evaluate and describe interprofessional collaboration between physicians and pharmacists. However, collecting further sociodemographic and contextual information seems necessary for enhanced interpretation of future results.
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Affiliation(s)
- Marina Weissenborn
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University, Heidelberg, Germany; Cooperation Unit Clinical Pharmacy, Heidelberg University, Heidelberg, Germany
| | - Ines Krass
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Connie Van
- Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Anna Dähne
- Clinical Pharmacy, Institute of Pharmacy, University of Greifswald, Greifswald, Germany
| | - Christoph A Ritter
- Clinical Pharmacy, Institute of Pharmacy, University of Greifswald, Greifswald, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University, Heidelberg, Germany; Cooperation Unit Clinical Pharmacy, Heidelberg University, Heidelberg, Germany
| | - Hanna M Seidling
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University, Heidelberg, Germany; Cooperation Unit Clinical Pharmacy, Heidelberg University, Heidelberg, Germany.
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Pharmacists' perspectives on medication reviews for long-term care residents with advanced dementia: a qualitative study. Int J Clin Pharm 2019; 41:950-962. [PMID: 31123899 DOI: 10.1007/s11096-019-00821-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 03/28/2019] [Indexed: 10/26/2022]
Abstract
Background Medication reviews by pharmacists have been shown to identify and reduce drug-related problems in long-term care residents. Objective To explore pharmacist perspectives of the Australian Government funded pharmacist-conducted residential medication management review and its role improving the quality and safety of prescribing in long-term care, in particular for those living with advanced dementia. Setting Australian Long-term care pharmacists. Method A qualitative research methodology approach using semi-structured interviews was used, with participants pharmacists with Residential Medication Management Review experience. Interviews were recorded, transcribed and coded utilising a meta-model of Physician-Community Pharmacy Collaboration in medication review. Main outcome measure Pharmacists' perspectives on the Residential Medication Management Review and how to improve the quality of reviews for residents with advanced dementia. Results Fifteen accredited pharmacists participated. The majority believed that the Residential Medication Management Review had the potential to improve the quality and safety of medicines but highlighted systemic issues that worked against collaborative practice. Participants emphasised the importance of three-way collaboration between general practitioners, pharmacists and nursing staff and highlighted key strategies for its optimisation. Conclusion Incorporating avenues for greater communication between team members can improve collaboration between health professionals and ultimately the quality of medication reviews.
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Parrish II RH, Casher D, van den Anker J, Benavides S. Creating a Pharmacotherapy Collaborative Practice Network to Manage Medications for Children and Youth: A Population Health Perspective. CHILDREN (BASEL, SWITZERLAND) 2019; 6:E58. [PMID: 30970616 PMCID: PMC6518168 DOI: 10.3390/children6040058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 02/07/2023]
Abstract
Children with special health care needs (CSHCN) use relatively high quantities of healthcare resources and have overall higher morbidity than the general pediatric population. Embedding clinical pharmacists into the Patient-Centered Medical Home (PCMH) to provide comprehensive medication management (CMM) through collaborative practice agreements (CPAs) for children, especially for CSHCN, can improve outcomes, enhance the experience of care for families, and reduce the cost of care. Potential network infrastructures for collaborative practice focused on CSHCN populations, common language and terminology for CMM, and clinical pharmacist workforce estimates are provided. Applying the results from the CMM in Primary Care grant, this paper outlines the following: (1) setting up collaborative practices for CMM between clinical pharmacists and pediatricians (primary care pediatricians and sub-specialties, such as pediatric clinical pharmacology); (2) proposing various models, organizational structures, design requirements, and shared electronic health record (EHR) needs; and (3) outlining consistent documentation of CMM by clinical pharmacists in CSHCN populations.
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Affiliation(s)
- Richard H Parrish II
- Department of Pharmacy Services, St. Christopher's Hospital for Children ⁻ American Academic Health System, 160 East Erie Avenue, Philadelphia, PA 19134, USA.
- School of Pharmacy, Virginia Commonwealth University, Richmond, VA 23298, USA.
| | - Danielle Casher
- Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA 19134, USA.
| | - Johannes van den Anker
- Universitäts-Kinderspital beider Basel (UKBB), Spitalstrasse 33, CH-4031 Basel, Switzerland.
- Children's National Health System, 111 Michigan Avenue, Washington, DC 20010, USA.
- Erasmus Medical Center-Sophia Children's Hospital, s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
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Mercer K, Neiterman E, Guirguis L, Burns C, Grindrod K. "My pharmacist": Creating and maintaining relationship between physicians and pharmacists in primary care settings. Res Social Adm Pharm 2019; 16:102-107. [PMID: 30956095 DOI: 10.1016/j.sapharm.2019.03.144] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/15/2019] [Accepted: 03/27/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Pharmacists and physicians are being increasingly encouraged to adopt a collaborative approach to patient care, and delivery of health services. Strong collaboration between pharmacists and physicians is known to improve patient safety, however pharmacists have expressed difficulty in developing interprofessional working relationships. There is not a significant body of knowledge around how relationships influence how and when pharmacists and physicians communicate about patient care. OBJECTIVES This paper examines how pharmacists and primary care physicians communicate with each other, specifically when they have or do not have an established relationship. METHODS Thematic analysis of data from semi-structured interviews with nine primary care physicians and 25 pharmacists, we examined how pharmacists and physicians talk about their roles and responsibilities in primary care and how they build relationships with each other. RESULTS We found that both groups of professionals communicated with each other in relation to the perceived scope of their practice and roles. Three emerging themes emerged in the data focusing on (1) the different ways physicians communicate with pharmacists; (2) insights into barriers discussed by pharmacists; and (3) how relationships shape collaboration and interactions. Pharmacists were also responsible for initiating the relationship as they relied on it more than the physicians. The presence or absence of a personal connection dramatically impacts how comfortable healthcare professionals are with collaboration around care. CONCLUSION The findings support and extend the existing literature on pharmacist-physician collaboration, as it relates to trust, relationship, and role. The importance of strong communication is noted, as is the necessity of improving ways to build relationships to ensure strong interprofessional collaboration.
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Affiliation(s)
- Kathryn Mercer
- School of Pharmacy, University of Waterloo, Ontario, Canada
| | - Elena Neiterman
- School of Public Health and Health Systems, University of Waterloo, Ontario, Canada
| | - Lisa Guirguis
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Alberta, Canada
| | - Catherine Burns
- Systems Design Engineering, Faculty of Engineering, University of Waterloo, Ontario, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Ontario, Canada.
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Vande Griend JP, Saseen JJ, Sullivan KJ, Anderson HD. Identifying patients likely to be referred for a clinical pharmacist intervention in a family medicine residency‐training clinic. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019. [DOI: 10.1002/jac5.1047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Joseph P. Vande Griend
- Department of Clinical Pharmacy University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado
| | - Joseph J. Saseen
- Department of Clinical Pharmacy University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado
| | - Katherine J. Sullivan
- Graduate Program in Pharmaceutical Sciences University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado
| | - Heather D. Anderson
- Department of Clinical Pharmacy University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences Aurora Colorado
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Perceptions and expectations of health care providers towards clinical pharmacy services in a mental health hospital in Qatar. Asian J Psychiatr 2019; 42:62-66. [PMID: 30965189 DOI: 10.1016/j.ajp.2019.03.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 03/13/2019] [Accepted: 03/25/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND With the growing burden of mental disorders, pharmacists are ideally positioned to play an important role in supporting people with a mental illness. However, the value of clinical pharmacists within mental health remains unrecognized by other healthcare professionals. AIMS The purpose of this study was to explore the perceptions and expectations of mental health professionals on the provision of clinical pharmacy services (CPS) at a psychiatric hospital. METHODS A cross-sectional, self-administered, online survey was administered to physicians and nurses working at a psychiatric hospital. Five-point likert scales were used to measure participant's perceptions and expectations about the CPS provided. Descriptive and inferential statistical analysis were undertaken. RESULTS Both physicians and nurses reported positive perceptions regarding the CPS provided at the hospital, although physicians agreement with positive statements was higher than those reported by nurses (mean likert scale score 4.76 and 4.45, respectively). There was a statistically significant positive association between participants' years of experience and agreeing that clinical pharmacy services are essential for achieving hospital accreditation (χ2 = 13.11, φ = 0.41, p = 0.04). A statistically significant positive association was noted between the physicians' current position and agreeing that pharmacists assist physicians in selecting more cost effective medication regimens (χ2 = 16.55, φ = 0.62, p = 0.04). CONCLUSION Physicians and nurses have mostly positive perceptions and expectations from clinical pharmacists at the psychiatric hospital. However, traditional clinical pharmacy services were more favorably viewed than those associated with advanced clinical roles such as prescribing and pharmacist-led medication management clinics.
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Carroll JC, Renner HM, McGivney MS, Grapsy J, McCormick K, Cooney SS, Coley KC. Using prescription dispensing data infographics to facilitate collaborative pharmacist-prescriber discussions on mutual patients. J Am Pharm Assoc (2003) 2019; 59:232-237.e1. [DOI: 10.1016/j.japh.2018.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/30/2018] [Accepted: 11/20/2018] [Indexed: 11/26/2022]
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Bitter K, Pehe C, Krüger M, Heuer G, Quinke R, Jaehde U. Pharmacist-led medication reviews for geriatric residents in German long-term care facilities. BMC Geriatr 2019; 19:39. [PMID: 30744564 PMCID: PMC6371600 DOI: 10.1186/s12877-019-1052-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 01/30/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The benefit of medication reviews for long-term care (LTC) residents has been generally recognized throughout health care systems. Whereas many studies showed the impact of comprehensive medication reviews performed by specialized clinical pharmacists, little is known about the impact of medication reviews performed by community pharmacists. Involving them in the provision of medication reviews may help satisfy the increasing demand for ensuring medication safety. METHODS Community pharmacists supplying drugs to the LTC facilities performed a medication review for German LTC residents aged at least 65 years and taking five or more drugs per day based on the patients' medication only. Documented potential drug-related problems (DRPs) and the implementation rate of pharmaceutical interventions were evaluated descriptively. To assess the quality of the medication reviews, we developed a corresponding reference system based on the analysis of two experienced clinical pharmacists. RESULTS Twelve pharmacies performed medication reviews for 94 LTC residents. Overall, the pharmacists documented 154 potential DRPs (mean 1.6 per patient, SD 1.5) of which the most common were drug-drug interactions (40%) followed by potentially inappropriate medication (PIM) (16%) and inappropriate dosages (14%). 33% of the pharmacists' interventions to solve DRPs were successfully implemented, mostly dosage adjustments. The identification of potentially severe drug-drug interactions and PIM showed the highest agreement (88 and 73%) with the reference system. CONCLUSIONS The medication review program of community pharmacists for LTC residents led to the identification of relevant DRPs. The reference system assessing the quality of the service can contribute to its transparency and reveals the potential for its improvement. The community pharmacists' knowledge of the LTC residents and their relation to the prescribers is crucial for providing successful medication reviews.
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Affiliation(s)
- Kerstin Bitter
- Department of Clinical Pharmacy, University of Bonn, An der Immenburg 4, 53121 Bonn, Germany
| | - Christina Pehe
- AOK Rheinland/Hamburg Health Insurance, Kasernenstr. 61, 40213 Düsseldorf, Germany
| | - Manfred Krüger
- Linner Apotheke, Rheinbabenstraße 170, 47809 Krefeld, Germany
| | - Gabriela Heuer
- Pharmacists’ Association North Rhine, Tersteegenstr. 12, 40474 Düsseldorf, Germany
| | - Regine Quinke
- Pharmacists’ Association North Rhine, Tersteegenstr. 12, 40474 Düsseldorf, Germany
| | - Ulrich Jaehde
- Department of Clinical Pharmacy, University of Bonn, An der Immenburg 4, 53121 Bonn, Germany
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Mc Namara K, Alzubaidi H, Jackson JK. Cardiovascular disease as a leading cause of death: how are pharmacists getting involved? INTEGRATED PHARMACY RESEARCH AND PRACTICE 2019; 8:1-11. [PMID: 30788283 PMCID: PMC6366352 DOI: 10.2147/iprp.s133088] [Citation(s) in RCA: 231] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cardiovascular diseases (CVDs) are a leading cause of death globally. This article explores the evidence surrounding community pharmacist interventions to reduce cardiovascular events and related mortality and to improve the management of CVD risk factors. We summarize a range of systematic reviews and leading randomized controlled trials and provide critical appraisal. Major observations are that very few trials directly measure clinical outcomes, potentially owing to a range of challenges in this regard. By contrast, there is an extensive, high-quality evidence to suggest that improvements can be achieved for key CVD risk factors such as hypertension, dyslipidemia, tobacco use, and elevated hemoglobin A1c. The heterogeneity of interventions tested and considerable variation of the context under which implementation occurred suggest that caution is warranted in the interpretation of meta-analyses. It is highly important to generate evidence for pharmacist interventions in developing countries where a majority of the global CVD burden will be experienced in the near future. A growing capacity for clinical registry trials and data linkage might allow future research to collect clinical outcomes data more often.
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Affiliation(s)
- Kevin Mc Namara
- School of Medicine, Deakin University, Geelong, VIC, Australia,
- Deakin Health Economics, Centre for Population Health, Deakin University, Geelong, VIC, Australia,
- Centre for Medicine Use & Safety, Faculty of Pharmacy & Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia,
| | - Hamzah Alzubaidi
- Institute for Medical Research and College of Pharmacy, University of Sharjah, Sharjah, Sharjah, United Arab Emirates
| | - John Keith Jackson
- Centre for Medicine Use & Safety, Faculty of Pharmacy & Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia,
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Makdessi CJ, Day C, Chaar BB. Challenges faced with opioid prescriptions in the community setting - Australian pharmacists' perspectives. Res Social Adm Pharm 2019; 15:966-973. [PMID: 30819418 DOI: 10.1016/j.sapharm.2019.01.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 01/22/2019] [Accepted: 01/29/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Prescription opioids (POs) are well recognised for their role in pain management. However over recent years, use of POs has become an increasingly complex public health issue, with the emergence of increasing quantities of POs being misused and abused. Pharmacists represent the 'gatekeepers' of medicines, which can be a challenging role, relating in particular to POs. OBJECTIVE This study aimed to gain insight into the challenges Australian community pharmacists experience in the dispensation of POs. SETTING Sydney Australia. METHOD Twenty-five pharmacists were recruited from suburbs in and around Sydney, Australia. Pharmacists were interviewed using an in-depth, semi-structured protocol. All interviews were audio-recorded, transcribed and thematically analysed. MAIN OUTCOME MEASURE Identification of issues/factors that may influence the dispensing of POs. RESULTS Pharmacists were reportedly confronted with several issues in the dispensing of POs, particularly in relation to the patient and prescriber. Pharmacists reported some individuals becoming increasingly more "creative" in the methods used to obtain POs, rendering detection of potential abuse/misuse increasingly difficult. Poor professional relationships with prescribers-an apparent power dynamic between the two professions, and limited engagement with patients were issues also identified. The majority of participants suggested that an electronic monitoring database would help in the identification of PO abuse/misuse. CONCLUSION Education is required to emphasise the importance of inter-professional collaboration between pharmacists and prescribers, as is empathy in the pharmacist-patient relationship. Prescription drug monitoring programs and prescribers sending electronic prescriptions directly to the pharmacist were perceived as helpful initiatives to undertake.
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Affiliation(s)
- Clarissa J Makdessi
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Carolyn Day
- Discipline of Addiction Medicine, Central Clinical School, Sydney Medical School, The University of Sydney, Australia
| | - Betty B Chaar
- Pharmacy Practice and Professional Ethics, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, 2006, Australia.
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General practice pharmacists in England: Integration, mediation and professional dynamics. Res Social Adm Pharm 2019; 16:17-24. [PMID: 30755373 DOI: 10.1016/j.sapharm.2019.01.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 01/07/2019] [Accepted: 01/25/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND A number of key publications in recent years have advocated a more integrated vision of UK primary care involving increased multi-professional communication and understanding. This has resulted in a marked change in the roles being undertaken by pharmacists. Community pharmacists have traditionally provided a medicine supply function and treated minor ailments in addition to delivering a suite of locally commissioned services; however these functions have not necessarily been part of a programme of care involving the other clinicians associated with the patient. An integrated model of care would see much closer working between pharmacy and general practice but also with pharmacists not only working with, but in the practice, in an enhanced patient-facing role, trained as independent prescribers. This has implications for the dynamics amongst professionals in this environment. OBJECTIVES This exploratory multiple case study attempts to explore these changing dynamics across ten GP surgeries throughout the South-East of England. METHODS Semi-structured, in-depth interviews were conducted with one nurse, one pharmacist and one physician from each clinic, and survey data was collected from 38 patients who had appointments with a pharmacist. RESULTS The data suggested that the pharmacists who had enhanced roles perceived some uncertainty about their professional role and identity, which resulted in instability and insecurity and that this uncertainty led to both professional and interprofessional tension with their primary care colleagues. The survey data revealed that n = 35 (92%) patients stated they were 'very satisfied' or 'satisfied' with their appointment. And n = 37 (97%) were 'very comfortable' or 'comfortable' discussing their medications with the pharmacist. In addition, 36 patients (95%) reported that they strongly agreed or agreed with the clinical recommendations made by the pharmacist. CONCLUSIONS These findings are discussed in relation to role expansion and professional/interprofessional relations before key practical suggestions are offered.
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Turner K, Weinberger M, Renfro C, Ferreri S, Trygstad T, Trogdon J, Shea CM. The role of network ties to support implementation of a community pharmacy enhanced services network. Res Social Adm Pharm 2018; 15:1118-1125. [PMID: 30291004 DOI: 10.1016/j.sapharm.2018.09.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 07/10/2018] [Accepted: 09/25/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND Limited evidence exists on how to integrate community pharmacists into team-based care models, as the inclusion of community pharmacy services into alternative payment models is relatively new. To be successful in team-based care models, community pharmacies need to successfully build relationship with diverse stakeholders including providers, care managers, and patients. OBJECTIVES The aims of this study are to: (1) identify the role of network ties to support implementation of a community pharmacy enhanced services network, (2) describe how these network ties are formed and maintained, and (3) compare the role of network ties among high- and low-performing community pharmacies participating in an enhanced services network. METHODS Using a semi-structured interview guide, we interviewed 40 community pharmacy representatives responsible for implementation of a community pharmacy enhanced services program. We analyzed for themes using social network theory to compare network ties among 24 high- and 16 low-performing community pharmacies. RESULTS The study found that high-performing pharmacies had a greater diversity of network ties (e.g., relationships with healthcare providers, care managers, and public health agencies). High-performing pharmacies were able to use those ties to support implementation of NC-CPESN. High- and low-performing pharmacies used similar strategies for establishing ties with patients, such as motivational interviewing and assigning staff members to be responsible for engaging high-risk patients. High-performing pharmacies used additional strategies such as assessing patient preferences to support patient engagement, increasing patient receptivity towards enhanced services. CONCLUSIONS Community pharmacies may vary in their ability to develop relationships with other healthcare providers, care management and public agencies, and patients. As enhanced services interventions that require care coordination are scaled up and spread, additional research is needed to test implementation strategies that support community pharmacies with developing and maintaining relationships across a diverse group of stakeholders (e.g., healthcare providers, care managers, public health agencies, patients).
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Affiliation(s)
- Kea Turner
- Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, USA.
| | - Morris Weinberger
- Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, USA
| | - Chelsea Renfro
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, USA
| | - Stefanie Ferreri
- Division of Practice Advancement and Clinical Education, University of North Carolina Eshelman School of Pharmacy, USA
| | - Troy Trygstad
- Division of Practice Advancement and Clinical Education, University of North Carolina Eshelman School of Pharmacy, USA; Community Pharmacy Enhanced Services Network, Community Care of North Carolina, USA
| | - Justin Trogdon
- Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, USA
| | - Christopher M Shea
- Department of Health Policy and Management, University of North Carolina Gillings School of Global Public Health, Chapel Hill, USA
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Hasan S, Stewart K, Chapman CB, Kong DCM. Physicians’ perspectives of pharmacist-physician collaboration in the United Arab Emirates: Findings from an exploratory study. J Interprof Care 2018; 32:566-574. [DOI: 10.1080/13561820.2018.1452726] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- S. Hasan
- Department of Clinical Sciences, College of Pharmacy, Ajman University, Ajman, United Arab Emirates
| | - K. Stewart
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
| | - C. B. Chapman
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
| | - D. C. M. Kong
- Centre for Medicine Use and Safety, Monash University, Parkville, Australia
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Coomber P, Clavarino A, Ballard E, Luetsch K. Doctor–pharmacist communication in hospitals: strategies, perceptions, limitations and opportunities. Int J Clin Pharm 2018; 40:464-473. [DOI: 10.1007/s11096-018-0592-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 01/11/2018] [Indexed: 11/25/2022]
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Vinterflod C, Gustafsson M, Mattsson S, Gallego G. Physicians' perspectives on clinical pharmacy services in Northern Sweden: a qualitative study. BMC Health Serv Res 2018; 18:35. [PMID: 29361941 PMCID: PMC5781320 DOI: 10.1186/s12913-018-2841-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 01/15/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND In many countries, clinical pharmacists are part of health care teams that work to optimize drug therapy and ensure patient safety. However, in Sweden, clinical pharmacy services (CPSs) in hospital settings have not been widely implemented and regional differences exist in the uptake of these services. Physicians' attitudes toward CPSs and collaborating with clinical pharmacists may facilitate or hinder the implementation and expansion of the CPSs and the role of the clinical pharmacist in hospital wards. The aim of this study was to explore physicians' perceptions regarding CPSs performed at hospital wards in Northern Sweden. METHODS Face-to-face semi-structured interviews were conducted with a purposive sample of nine physicians who had previously worked with clinical pharmacists between November 2014 and January 2015. Interviews were digitally recorded, transcribed and analysed using a constant comparison method. RESULTS Different themes emerged regarding physicians' views of clinical pharmacy; two main interlinked themes were service factors and pharmacist factors. The service was valued and described in a positive way by all physicians. It was seen as an opportunity for them to learn more about pharmacological treatment and also an opportunity to discuss patient medication treatment in detail. Physicians considered that CPSs could improve patient outcomes and they valued continuity and the ability to build a trusting relationship with the pharmacists over time. However, there was a lack of awareness of the CPSs. All physicians knew that one of the pharmacist's roles is to conduct medication reviews, but most of them were only able to describe a few elements of what this service encompasses. Pharmacists were described as "drug experts" and their recommendations were perceived as clinically relevant. Physicians wanted CPSs to continue and to be implemented in other wards. CONCLUSIONS All physicians were positive regarding CPSs and were satisfied with the collaboration with the clinical pharmacists. These findings are important for further implementation and expansion of CPSs, particularly in Northern Sweden.
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Affiliation(s)
- Charlotta Vinterflod
- Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-90187 Umeå, Sweden
| | - Maria Gustafsson
- Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-90187 Umeå, Sweden
| | - Sofia Mattsson
- Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-90187 Umeå, Sweden
| | - Gisselle Gallego
- Department of Pharmacology and Clinical Neuroscience, Umeå University, SE-90187 Umeå, Sweden
- School of Medicine, The University of Notre Dame Australia, 160 Oxford Street, Darlinghurst, NSW 2010 Australia
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Mavronicolas HA, Laraque F, Shankar A, Campbell C. Understanding the drivers of interprofessional collaborative practice among HIV primary care providers and case managers in HIV care programmes. J Interprof Care 2017; 31:368-375. [PMID: 28388286 DOI: 10.1080/13561820.2016.1270921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Care coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.
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Affiliation(s)
- Heather A Mavronicolas
- a Bureau of HIV/AIDS Prevention and Control , New York City Department of Health and Mental Hygiene , Queens , New York , USA
| | - Fabienne Laraque
- b Viral Hepatitis Surveillance, Prevention and Control Program , New York City Department of Health and Mental Hygiene , Queens , New York , USA
| | - Arti Shankar
- c Department of Global Biostatistics and Data Science , Tulane University School of Public Health and Tropical Medicine , New Orleans , Louisiana , USA
| | - Claudia Campbell
- d Department of Global Health Management and Policy , Tulane University School of Public Health and Tropical Medicine , New Orleans , Louisiana , USA
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