GP pharmacists: stakeholder perspectives

What do patients, general practice staff and community pharmacists think about general practice pharmacists?

A new qualitative pilot study published in the Australian Journal of Primary Health has reviewed stakeholder perception about the role of the pharmacist in general practice.

Researchers from the University of Canberra, Capital Health Network and the Queensland University of Technology used self-report questionnaires and qualitative semi-structured interviews to gather perspectives of patients, practice staff and community pharmacists that had interacted with a practice pharmacist.

The study was conducted across three general practices in the ACT, each of which employed a part-time (15.2-16 hours per week) non-dispensing pharmacist for 12 months as part of an initiative of the Capital Health Network – ACT’s Primary Health Network.

Activities that the three pharmacists performed in their role included conducting clinical audits, medication review, patient education, community pharmacy liaison about complex patients, and administration.

Response rates for the questionnaires were 48% for patients (n = 44) and 36% (n = 42) for staff. Opinions were further explored by individual semi-structured interviews (n = 20).

Patient respondents indicated that they mainly heard about the general practice pharmacist from doctors (66%), while about 80% of healthcare workers  said they had made referrals to the pharmacist.

The main reasons for these referrals included medication review, patient education, medication adherence and smoking cessation.

About 60% of patients had seen the general practice pharmacist at least once, while 32% had seen them twice, 7% three times and 2% four times. Average consultation time with the pharmacist was 40 minutes (range: 20-100 minutes).

Medicare funding of practice pharmacists was supported by 73% of patients.

Continued integration of pharmacists in general practice was supported by both patients and healthcare workers, with mean Likert scores of 4.4 and 4.4 out of 5 respectively.

Positive feedback came from all stakeholders including the patients, GPs, practice nurses and practice pharmacists themselves.

“We’ve been able to scale down the amount of medications and reduce the pill burden for these patients which obviously improves adherence,” said one GP.

“Complicated people, and sometimes when they come out of … hospital or if they’ve visited two or three specialists, then each one of them has made a small change, and getting [the practice pharmacist] to go over .. what they are actually, really taking now, as opposed to what my computer thinks they’re taking, has been incredibly helpful,” said another GP.

Within the context of being a member of the practice team, there was recognition of the importance of working within the scope of practice.

“I don’t want to be taking away work from the nurses,” said one general practice pharmacist.

Negative perceptions of practice pharmacists mainly came from community pharmacists, say the authors.

Their main concerns were about low effect on patient care and the lack communication with the community pharmacist.

“No feedback from the patients whatsoever, and certainly I haven’t seen any major changes,” said one community pharmacist.

Limitations for the study include low participant numbers, low response rate to the questionnaires and no knowledge of non-respondents. It was also conducted in one Australian urban city, and general practices in the study volunteered to be involved.

See the full study here

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