Introduction
The Community Pharmacy Medicines Management Project (CPMMP) was a multi-centre
randomised, controlled trial evaluating the contribution of community
pharmacists to improving health outcomes for patients with coronary heart
disease (CHD). The service consisted of a pharmacist-initiated review of
patients’ medication regimens drawing on clinical information transcribed from
the patient’s medical notes, coupled with a face-to-face consultation with the
patient over a twelve month intervention period. Pharmacists were expected to
make recommendations to the general practitioner (GP) and patient regarding the
appropriateness of medication regimens and provide relevant lifestyle advice,
following-up the patient’s progress if deemed necessary. This paper presents
findings about community pharmacists’ perceptions and experiences of taking
part in the CPMMP.
Methods
Ethics approval was obtained. Sixty-seven pharmacists took part in the CPMMP.
Thirty-five pharmacists provided feedback through eight focus groups and two
individual telephone interviews, during the first four months of the project.
Follow-up data were obtained from 28 pharmacists by conducting semi-structured
telephone interviews at the end of the twelve month intervention period.
Pharmacists were contacted via telephone calls and asked to provide feedback.
The focus groups and interviews were tape-recorded, transcribed verbatim and
analysed using the principles of grounded theory.
Findings
Pharmacists expressed positive views of participating in the CPMMP. The
benefits of participation included having a greater input into patient care and
an opportunity to utilize their clinical skills. Difficulties encountered
included lack of access to patients’ medical records, GPs’ resistance to
pharmacists’ recommendations and time constraints on following-up patients
over the 12 month intervention period. Over half the pharmacists believed
relationships with GPs had improved as a result of the project, although some
were concerned that the project had been hampered by GPs’ perceptions of
pharmacists as ‘shop-keepers’, rather than health professionals. Although
the majority of pharmacists thought this model of the CPMMP worked, the general
consensus held by pharmacists was the CPMMP was not a sustainable service within
the current organizational framework of community pharmacy.
Discussion
Although the pharmacists were positive about participating in CPMMP, a
series of practical and attitudinal barriers need to be overcome in order to
develop medicines management services. Indeed, some of the issues raised by this
research have been noted in other studies.1,2 We suggest that these
issues need to be addressed at the policy and inter-professional level in order
to take forward effective collaborative work between GPs and pharmacists.
References
- Hughes CM, McGann S. Perceived interprofessional barriers between community
pharmacists and general practitioners: a qualitative assessment. BJGP 2003;
53(493):600-606
- Adamcik BA, Ransford HE, Oppenhemer P, et al. New clinical roles for
pharmacists: a study of role expansion. Social Science and Medicine 1986;
23(11) 1187-1200
