Working together: what helps and hinders

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GPs and pharmacists work best together when they understand and value one another’s expertise, a new study shows

The research, published in the British Journal of General Practice by researchers at the Centre for Academic Primary Care at the University of Bristol, aimed to explore GP and pharmacist perspectives on collaborative working within the context of optimising medications for patients with multimorbidity.

It involved asking GPs and pharmacists about their views on what helps and what hinders them from working together to make the best use of medicines for patients with multiple health problems.

The study found that “knowing each other” and a good working relationship were key to working together well.

GPs in practices that employed a pharmacist tended to value pharmacists’ professional expertise more than GPs in practices without one, while pharmacists who were not known to GPs felt under-valued.

The small-scale study included a qualitative analysis of semi-structured interviews with 13 GPs and 10 pharmacists working in the West of England, Northern England, and Scotland.

“GPs from surgeries that employed a pharmacist tended to value their expertise more than GPs who had not worked with one,” the authors wrote.

“Three key themes were identified: resources and competing priorities; responsibility; and professional boundaries.

“GPs valued pharmacist recommendations that were perceived to improve patient safety, as opposed to those that were technical and unlikely to benefit the patient.

However, “Pharmacists who were not known to GPs felt undervalued and wanted feedback from the GPs about their recommendations, particularly those that were not actioned.”

GPs had mixed views about whether pharmacists should have the authority to make changes to patients’ medicines, with some GPs valuing pharmacists’ knowledge of medicines but preferring to remain in control of the decisions.

GPs reported that pharmacist-led medicine reviews were unlikely to impact much on GP workload as GPs were doing these in a time efficient way, for example during a ten minute appointment alongside other problems.

Pharmacists would require more time, for example during a 20-minute appointment focused just on medicines. Other tasks that had a greater impact on reducing GP workload, such as sorting out prescription requests, took priority for pharmacists.

Dr Polly Duncan, lead author and a GP and National Institute for Health Research (NIHR) In-Practice Fellow at the Centre for Academic Primary Care, said: “Many UK GP practices now employ a pharmacist to help with workload pressures but little is known about how GPs and pharmacists work together”.

“Pharmacists could play an important role in making sure that patients who have multiple health problems are happy to take their medicines and that the benefits outweigh any potential harm or side effects.

“Our study suggests that building trusting relationships through face-to-face meetings between GPs and pharmacists is key to understanding and valuing one another’s expertise.

“This was a small qualitative study and more research is needed to establish the roles of practice pharmacists and whether they improve patient health outcomes.”

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  1. Debbie Rigby

    No surprises here. Collaborative practice builds trust and respect.

    • Jarrod McMaugh

      I think it’s worth pointing out that trust and respect also leads to collaboration…. or more specifically, trust and respect are needed for collaboration.

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