Register      Login
Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

Changing perspectives of the role of community pharmacists: 1998 – 2012

Linda Bryant 1 , Joanne Maney 2 , Nataly Martini 2
+ Author Affiliations
- Author Affiliations

1 Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Private bag 92019, Auckland, New Zealand

2 School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private bag 92019, Auckland, New Zealand

Correspondence to: Nataly Martini, School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Private bag 92019, Auckland 1010, New Zealand. Email: n.martini@auckland.ac.nz

Journal of Primary Health Care 9(1) 34-46 https://doi.org/10.1071/HC16032
Published: 10 February 2017

Journal Compilation © Royal New Zealand College of General Practitioners 2017.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Abstract

INTRODUCTION: In New Zealand, extended medicines management roles proposed for pharmacists include the optimisation and monitoring of medicines in patients with long-term conditions through greater collaboration with general practitioners (GPs). Although some collaborative roles have been successfully implemented in hospitals, barriers for both pharmacists and GPs hinder interprofessional working relationships in the community.

AIM: To compare data from a 2012 study with two previous studies (1998, 2002) examining perceptions of community pharmacists and GPs of the expanding medicines management roles of community pharmacists.

METHODS: In 2012, a survey, modelled on the 1998 and 2002 studies, was sent to 600 community pharmacists and 600 GPs. Analyses considered the five-point Likert scale to be a continuous variable. A change of ≥ 10% between any two surveys indicated a relevant change for comparison.

RESULTS: Increasing agreement, which differed considerably between professions, was apparent for most expanding medicine management roles over the 14 study years. In all three studies, pharmacists were open to expanding their roles to include monitoring, screening, advisory and prescribing roles. GPs were most accepting of the traditional dispensing role with a positive shift towards pharmacists’ involvement in medicines management over time.

DISCUSSION: Over 14 years, GPs became more accepting of community pharmacists’ involvement in extended medicines management roles, although still had low acceptance of the more clinical roles. Pharmacists considered increased involvement in medicines management as their role, but appeared to lack confidence in their ability to do this role.

KEYWORDS: Pharmacy services; general practitioners; primary health care; workforce


References

[1]  Rigby D. Collaboration between doctors and pharmacists in the community. Aust Prescr 2010; 33 191–3.
Collaboration between doctors and pharmacists in the community.Crossref | GoogleScholarGoogle Scholar |

[2]  Edmunds J, Calnan MW. The reprofessionalisation of community pharmacy? An exploration of attitudes to extended roles for community pharmacists amongst pharmacists and General Practitioners in the United Kingdom. Soc Sci Med 2001; 53 943–55.
The reprofessionalisation of community pharmacy? An exploration of attitudes to extended roles for community pharmacists amongst pharmacists and General Practitioners in the United Kingdom.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvnvVKntQ%3D%3D&md5=76859536d68ad95a4a687237fd2d572eCAS |

[3]  Hughes CM, McCann S. Perceived interprofessional barriers between community pharmacists and GPs: a qualitative assessment. Br J Gen Pract 2003; 53 600–6.

[4]  Zellmer WA. Pharmacy’s future: transformation, diffusion, and imagination. Am J Health Syst Pharm 2010; 67 1199–204.
Pharmacy’s future: transformation, diffusion, and imagination.Crossref | GoogleScholarGoogle Scholar |

[5]  Bryant LJ, Coster G, Gamble GD, McCormick RN. GPs’ and pharmacists’ perceptions of the role of community pharmacists in delivering clinical services. Res Social Adm Pharm 2009; 5 347–62.
GPs’ and pharmacists’ perceptions of the role of community pharmacists in delivering clinical services.Crossref | GoogleScholarGoogle Scholar |

[6]  Bryant L, Coster G, McCormick R. Community pharmacist perceptions of clinical medication reviews. J Prim Health Care 2010; 2 234–42.

[7]  Scahill S, Harrison J, Sheridan J. Pharmacy under the spotlight: New Zealand pharmacists’ perceptions of current and future roles and the need for accreditation. Int J Pharm Pract 2010; 18 59–62.
Pharmacy under the spotlight: New Zealand pharmacists’ perceptions of current and future roles and the need for accreditation.Crossref | GoogleScholarGoogle Scholar |

[8]  Howard M, Trim K, Woodward C, et al Collaboration between community pharmacists and family physicians: lessons learned from the Seniors Medication Assessment Research Trial. J Am Pharm Assoc (Wash DC) 2003; 43 566–72.
Collaboration between community pharmacists and family physicians: lessons learned from the Seniors Medication Assessment Research Trial.Crossref | GoogleScholarGoogle Scholar |

[9]  Dunlop JA, Shaw JP. Community pharmacists’ perspectives on pharmaceutical care implementation in New Zealand. Pharm World Sci 2002; 24 224–30.
Community pharmacists’ perspectives on pharmaceutical care implementation in New Zealand.Crossref | GoogleScholarGoogle Scholar |

[10]  Kucukarslan S, Lai S, Dong Y, et al Physician beliefs and attitudes toward collaboration with community pharmacists. Res Social Adm Pharm 2011; 7 224–32.
Physician beliefs and attitudes toward collaboration with community pharmacists.Crossref | GoogleScholarGoogle Scholar |

[11]  Bryant L, Coster G, McCormick R. General practitioner perceptions of clinical medication reviews undertaken by community pharmacists. J Prim Health Care 2010; 2 225–33.

[12]  Rubio-Valera M, Jové A, Hughes C, et al Factors affecting collaboration between GPs and community pharmacists: a qualitative study. BMC Health Serv Res 2012; 12 188
Factors affecting collaboration between GPs and community pharmacists: a qualitative study.Crossref | GoogleScholarGoogle Scholar |

[13]  Ambler S. GPs and community pharmacists: times they are a-changing. Br J Gen Pract 2003; 53 594–5.

[14]  Bradley F, Elvey R, Ashcroft DM, et al The challenge of integrating community pharmacists into the primary health care team: a case study of local pharmaceutical services (LPS) pilots and interprofessional collaboration. J Interprof Care 2008; 22 387–98.
The challenge of integrating community pharmacists into the primary health care team: a case study of local pharmaceutical services (LPS) pilots and interprofessional collaboration.Crossref | GoogleScholarGoogle Scholar |

[15]  Scahill S, Harrison J, Carswell P, Shaw J. Health care policy and community pharmacy: implications for the New Zealand primary health care sector. N Z Med J 2010; 123 41–51.

[16]  Muijrers P, Knottnerus JA, Sijbrandij J, et al Changing relationships: attitudes and opinions of GPs and pharmacists regarding the role of the community pharmacist. Pharm World Sci 2003; 25 235–41.
Changing relationships: attitudes and opinions of GPs and pharmacists regarding the role of the community pharmacist.Crossref | GoogleScholarGoogle Scholar |

[17]  Hatah E, Braund R, Duffull S, Tordoff J. GPs’ perceptions of pharmacists’ new services in New Zealand. Int J Clin Pharm 2012; 34 364–73.
GPs’ perceptions of pharmacists’ new services in New Zealand.Crossref | GoogleScholarGoogle Scholar |

[18]  Snyder ME, Zillich AJ, Primack BA, et al Exploring successful community pharmacist-physician collaborative working relationships using mixed methods. Res Social Adm Pharm 2010; 6 307–23.
Exploring successful community pharmacist-physician collaborative working relationships using mixed methods.Crossref | GoogleScholarGoogle Scholar |

[19]  Bradley F, Ashcroft DM, Noyce PR. Integration and differentiation: a conceptual model of general practitioner and community pharmacist collaboration. Res Social Adm Pharm 2012; 8 36–46.
Integration and differentiation: a conceptual model of general practitioner and community pharmacist collaboration.Crossref | GoogleScholarGoogle Scholar |

[20]  Pojskic N, MacKeigan L, Boon H, et al Ontario family physician readiness to collaborate with community pharmacists on drug therapy management. Res Social Adm Pharm 2011; 7 39–50.
Ontario family physician readiness to collaborate with community pharmacists on drug therapy management.Crossref | GoogleScholarGoogle Scholar |

[21]  Zillich AJ, Doucette WR, Carter BL, Kreiter CD. Development and initial validation of an instrument to measure physician-pharmacist collaboration from the physician perspective. Value Health 2005; 8 59–66.
Development and initial validation of an instrument to measure physician-pharmacist collaboration from the physician perspective.Crossref | GoogleScholarGoogle Scholar |

[22]  Norton D, Measday J, Grenfell R, et al GP-pharmacist liaison: a rural case study. Aust Fam Physician 2003; 32 191–2.

[23]  Blenkinsopp A, Tann J, Evans A, Grime J. Opportunity or threat? General practitioner perceptions of pharmacist prescribing. Int J Pharm Pract 2008; 16 29–34.
Opportunity or threat? General practitioner perceptions of pharmacist prescribing.Crossref | GoogleScholarGoogle Scholar |

[24]  Bryant L. Evaluation of the barrier to, and implementation of, comprehensive pharmaceutical care in New Zealand [Thesis]. Auckland: University of Auckland; 2006.

[25]  Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990; 47 533–43.
| 1:STN:280:DyaK3c7ps1Sgsw%3D%3D&md5=bed47e0e73e3e5f19c8c9d77401ddaa1CAS |

[26]  Ministry of Health. New Zealand Health Strategy: future direction [Internet]. Wellington: Ministry of Health; 2016. [cited 2016 September 2]. Available from: www.health.govt.nz/new-zealand-health-system/new-zealand-health-strategy-future-direction

[27]  Mays N. Reorienting the New Zealand health care system to meet the challenge of long term conditions in a fiscally constrained environment. Paper prepared for New Zealand Treasury Long-term Fiscal External Panel, Nov 2012, and Chair of Public Finance, Victoria University of Wellington and New Zealand Treasury conference, Affording our Future, Wellington, 10–11 December 2013. Available from: www.hiirc.org.nz/page/37816

[28]  Hook S, Windle J. Community pharmacy influenza immunisation increases vaccine uptake and gains public approval. Aust N Z J Public Health 2013; 37 489–90.
Community pharmacy influenza immunisation increases vaccine uptake and gains public approval.Crossref | GoogleScholarGoogle Scholar |

[29]  Rigby D. Medication review: learnings from Old Blighty. Aust J Pharmacy 2010; 91 34–5.

[30]  Krska J, Cromarty J, Arris F, et al Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care (statistical data included). Age Ageing 2001; 30 205–11.
Pharmacist-led medication review in patients over 65: a randomized, controlled trial in primary care (statistical data included).Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MzovVKnsA%3D%3D&md5=ae1f200a86e95b74dcac0c29d72db060CAS |

[31]  Harding G, Wilcock M. Community pharmacists’ perceptions of medicines use reviews and quality assurance by peer review. Pharm World Sci 2010; 32 381–5.
Community pharmacists’ perceptions of medicines use reviews and quality assurance by peer review.Crossref | GoogleScholarGoogle Scholar |

[32]  Latif A, Pollock K, Boardman HF. The contribution of the Medicines Use Review (MUR) consultation to counseling practice in community pharmacies. Patient Educ Couns 2011; 83 336–44.
The contribution of the Medicines Use Review (MUR) consultation to counseling practice in community pharmacies.Crossref | GoogleScholarGoogle Scholar |

[33]  Porteous T, Bond C. Evaluation of a pharmacist-managed repeat dispensing system: the GP perspective. Int J Pharm Pract 2005; 13 41–6.
Evaluation of a pharmacist-managed repeat dispensing system: the GP perspective.Crossref | GoogleScholarGoogle Scholar |

[34]  Bond C, Matheson C, Williams S, et al Repeat prescribing: a role for community pharmacists in controlling and monitoring repeat prescriptions. Br J Gen Pract 2000; 50 271–5.
| 1:STN:280:DC%2BD3cvgtVyitQ%3D%3D&md5=bed4ccb92cfe3712f0c7e1846413e842CAS |

[35]  Scahill S, Harrison J, Sheridan J. The ABC of New Zealand’s ten year vision for pharmacists: awareness, barriers and consultation. Int J Pharm Pract 2009; 17 135–42.
The ABC of New Zealand’s ten year vision for pharmacists: awareness, barriers and consultation.Crossref | GoogleScholarGoogle Scholar |

[36]  Rosenthal M, Austin Z, Tsuyuki RT. Are pharmacists the ultimate barrier to pharmacy practice change? Can Pharm J 2010; 143 37–42.
Are pharmacists the ultimate barrier to pharmacy practice change?Crossref | GoogleScholarGoogle Scholar |

[37]  Kay OC, Bajorek BV, Brien JA. Pharmacist prescribing activities – an electronic survey on the opinions of Australian pharmacists. J Pharmacy Pract Res 2006; 36 199–203.
Pharmacist prescribing activities – an electronic survey on the opinions of Australian pharmacists.Crossref | GoogleScholarGoogle Scholar |

[38]  Gidman W, Ward P, McGregor L. Understanding public trust in services provided by community pharmacists relative to those provided by GPs: a qualitative study. BMJ Open 2012; 2 e000939
Understanding public trust in services provided by community pharmacists relative to those provided by GPs: a qualitative study.Crossref | GoogleScholarGoogle Scholar |

[39]  Anscombe J, Thomas M, Plimley J. The future of community pharmacy in England. London: A.T. Kearney’s Health Practice; 2012. Available from: www.atkearney.com/documents/10192/649132/The+Future+of+Community+Pharmacy.pdf/1838dede-b95a-4989-8600-6b435bd00171

[40]  Silcock J, Raynor DK, Petty D. The organisation and development of primary care pharmacy in the United Kingdom. Health Policy 2004; 67 207–14.
The organisation and development of primary care pharmacy in the United Kingdom.Crossref | GoogleScholarGoogle Scholar |