|
GENERAL
PRACTITIONERS’ PERCEPTIONS OF INTERPROFESSIONAL COLLABORATION WITH COMMUNITY
PHARMACISTS
Stacey
Sadler*, Paul Bissell*, Claire Anderson* & Anthony Avery**
on behalf of the Community Pharmacy Medicines Management Project
evaluation team
*Centre for Pharmacy, Health and Society, School of Pharmacy, University
of Nottingham, NG7 2RD **Division of Primary Care, School of Community
Health Sciences, University of Nottingham
Stacey.Sadler@nottingham.ac.uk
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 patients’ medical notes, coupled with a face-to-face consultation with the
patient. Pharmacists were expected to make recommendations to the general
practitioner (GP) and patient concerning the appropriateness of medication
regimens and provide relevant lifestyle advice. This paper presents findings
about GPs’ perceptions and experiences of taking part in the CPMMP.
Methods
Ethical approval was obtained. Data collection was via semi-structured
telephone interviews, given the limitations on GPs’ time coupled with
travelling costs. In order to recruit GPs, practice managers in each surgery
were sent a letter requesting an interview with a GP, augmented by telephone
calls to each practice. Thirty-seven GP practices took part in the CPMMP, of
whom 21 GPs were interviewed. The interviews were tape-recorded and transcribed,
and analysed using the principles of grounded theory.
Findings
Although there was strong support for the project from some GPs, a variety
of perspectives were expressed. Six GPs expressed positive overall views, eight
expressed ambivalent views, whilst the remainder were more negative than
positive. Positive issues raised included the opportunity for patients to have
their medication reviewed and to raise any medication concerns with another
health professional. The majority of GPs reported that patient feedback
concerning the project had been positive. GPs raised concerns about the workload
associated with the project, and duplication of CHD related recommendations. GPs
believed that this was exacerbated because pharmacists did not have access to
patients’ medical records, although GPs had concerns about pharmacists
accessing these. A small number of GPs were anxious that commercial pressures
might influence pharmacists’ clinical recommendations. GPs also expressed
mixed views about whether relationships between GPs and pharmacists had been
strengthened by the project and about whether the service should be made more
widely available.
Discussion
Although there were strong pockets of support for the project, overall
assessments of participating in the CPMMP were mixed. A number of the issues
identified here are common to other studies in this area.1,2
Practical and inter-professional factors will need to be addressed in order to
maximise the potential for collaborative working between GPs and pharmacists.
References
- Hughes CM, McCann S. Perceived inter-professional barriers between community
pharmacists and general practitioners: a qualitative assessment. BJGP 2003;
53(493):600-606.
- Gilbert L. To diagnose, prescribe and dispense: whose right is it? The
ongoing struggle between pharmacy and medicine in South Africa. Current
Sociology 2001; 49(3):97-118.
Presented at the HSRPP Conference 2005, Reading
|
