Register      Login
Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
Shopping Cart: ( empty )
You are here: Home > Journals > HC > HC24049
RESEARCH ARTICLE (Open Access)
Online Early

Practice pharmacists in the primary healthcare team in Aotearoa New Zealand: a national survey

Janet McDonald https://orcid.org/0000-0003-4761-5371 1 * , Caroline Morris https://orcid.org/0000-0002-8751-0657 2 , Tara N. Officer https://orcid.org/0000-0002-2322-2525 3 , Jacqueline Cumming https://orcid.org/0000-0002-8369-2465 1 , Jonathan Kennedy https://orcid.org/0000-0002-5676-6764 2 , Lynne Russell https://orcid.org/0000-0002-5360-5391 1 , Eileen McKinlay https://orcid.org/0000-0003-3333-5723 4 , Mona Jeffreys https://orcid.org/0000-0002-2617-0361 1
+ Author Affiliations
- Author Affiliations

1 Te Hikuwai Rangahau Hauora–Health Services Research Centre, Te Herenga Waka–Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand. Email: jackie.cumming@vuw.ac.nz, lynne.russell@vuw.ac.nz, mona.jeffreys@vuw.ac.nz

2 Department of Primary Health Care & General Practice, Te Tari Hauora Tūmatanui, University of Otago Wellington, PO Box 7343, Wellington 6242, New Zealand. Email: caroline.morris@otago.ac.nz, jonathan.kennedy@otago.ac.nz

3 Te Kura Tapuhi Hauora | School of Nursing, Midwifery, and Health Practice, Te Herenga Waka–Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand. Email: tara.officer@vuw.ac.nz

4 Centre for Interprofessional Education, Division of Health Sciences, University of Otago, PO Box 56, Dunedin 9054, New Zealand. Email: eileen.mckinlay@otago.ac.nz

* Correspondence to: janet.mcdonald@vuw.ac.nz

Handling Editor: Tim Stokes

Journal of Primary Health Care https://doi.org/10.1071/HC24049
Submitted: 8 April 2024  Accepted: 21 June 2024  Published: 11 July 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

The integration of pharmacists into general practice settings is increasingly common internationally. Within Aotearoa New Zealand, the role has evolved variably in different regions. Recent health policy and professional guidance support further development.

Aim

To describe the current status of pharmacists working in primary healthcare settings other than community pharmacy.

Methods

An online survey of all pharmacists in Aotearoa New Zealand primary healthcare settings was conducted in 2022, and covered employment, current services, patient consultations, relationships with other health professionals, and service costs and benefits. Descriptive statistical analyses were performed.

Results

Responses from 39 pharmacists (~35% response rate) working in primary healthcare practice roles are reported. Most were female (84%), New Zealand European (81%), and 45% had <5 years’ experience in this setting. The most common service provided was responding to medicines information queries from other health professionals (87%). Most also offered one or more medicines management services: medicines use review (44%), medicines therapy assessment (62%), and medicines optimisation (69%). One-third were prescribing or repeat prescribing pharmacists; non-prescribers expressed strong interest in future prescribing roles. Most (86%) undertook patient consultations with varied capacity to do more. Key perceived benefits for patients included improved health outcomes and medicines understanding; benefits for the health services included supporting the workloads of busy primary healthcare staff.

Discussion

Practice pharmacists have both patient- and practice-facing roles. The proportion with a prescribing qualification has increased over time. There is some capacity for additional consultations, but this requires funding, space and time spent in a service/setting.

Keywords: Aotearoa New Zealand, clinical pharmacists, cross-sectional survey, general practice, pharmacists, practice pharmacists, primary health care.

References

1  NHS England. Clinical pharmacists. n.d. Available at https://www.england.nhs.uk/gp/expanding-our-workforce/cp-gp/ [Accessed 20 June 2024].

2  NHS Wales. Pharmacy. n.d. Available at https://primarycareone.nhs.wales/careers/primary-care-roles-in-wales/pharmacy/ [Accessed 20 June 2024].

3  Northern GP Federation Support Unit. General practice pharmacists. 2023. Available at https://www.northernfsu.co.uk/general-practice-pharmacists [Accessed 20 June 2024].

4  Freeman C, Rigby D, Aloizos J, et al. The practice pharmacist: a natural fit in the general practice team. Aust Prescr 2016; 39(6): 211-4.
| Crossref | Google Scholar | PubMed |

5  Freeman CR, Scott IA, Hemming K, et al. Reducing Medical Admissions and Presentations Into Hospital through Optimising Medicines (REMAIN HOME): a stepped wedge, cluster randomised controlled trial. Med J Aust 2021; 214(5): 212-7.
| Crossref | Google Scholar | PubMed |

6  Australian Medical Association. General practice pharmacists - Improving patient care. 2015. Available at https://ama.com.au/article/general-practice-pharmacists-improving-patient-care [Accessed 20 June 2024].

7  Gillespie U, Dolovich L, Dahrouge S. Activities performed by pharmacists integrated in family health teams: results from a web-based survey. Can Pharm J 2017; 150(6): 407-16.
| Crossref | Google Scholar | PubMed |

8  Coe AB, Choe HM. Pharmacists supporting population health in patient-centered medical homes. Am J Health Syst Pharm 2017; 74(18): 1461-6.
| Crossref | Google Scholar | PubMed |

9  Dodd MA, Haines SL, Maack B, et al. ASHP statement on the role of pharmacists in primary care. Am J Health Syst Pharm 2022; 79(22): 2070-8.
| Crossref | Google Scholar | PubMed |

10  Bradley F, Seston E, Mannall C, et al. Evolution of the general practice pharmacist’s role in England: a longitudinal study. Br J Gen Pract 2018; 68(675): e727-34.
| Crossref | Google Scholar | PubMed |

11  Stretch G. Pharmacists are the success story of general practice, and they are here to stay. Pharm J 2023; 311(7975):.
| Crossref | Google Scholar |

12  Tan EC, Stewart K, Elliott RA, et al. Pharmacist services provided in general practice clinics: a systematic review and meta-analysis. Res Social Admin Pharm 2014; 10(4): 608-22.
| Crossref | Google Scholar | PubMed |

13  Komwong D, Greenfield G, Zaman H, et al. Clinical pharmacists in primary care: a safe solution to the workforce crisis? J R Soc Med 2018; 111(4): 120-4.
| Crossref | Google Scholar | PubMed |

14  Syafhan NF, Al Azzam S, Williams SD, et al. General practitioner practice-based pharmacist input to medicines optimisation in the UK: pragmatic, multicenter, randomised, controlled trial. J Pharm Policy Pract 2021; 14(1): 121-4.
| Crossref | Google Scholar | PubMed |

15  Pharmacy Council of New Zealand. Position Statement: Council expectations for pharmacists practising in clinical roles in general practice. 2019. Available at https://pharmacycouncil.org.nz/wp-content/uploads/2021/03/Pharmacists-practising-in-clinical-roles-in-GP-position-statement-1.pdf [Accessed 20 June 2024].

16  Clinical Advisory Pharmacists Association. Service development toolkit for general practice based clinical pharmacists. 2019. Available at https://www.psnz.org.nz/Folder?Action=View%20File&Folder_id=166&File=Service%20Development%20Toolkit%20for%20CP%20in%20GPs%20June%202019%20CAPA%20%20final1446.pdf [Accessed 20 June 2024].

17  Health and Disability System Review. Health and disability system review – final report – Pūrongo whakamutunga. 2020. Available at https://www.health.govt.nz/publication/health-and-disability-system-review-final-report [Accessed 20 June 2024].

18  Health New Zealand–Te Whatu Ora. Primary, community, and rural early actions programme. 2023. Available at https://www.tewhatuora.govt.nz/for-the-health-sector/primary-community-and-rural-early-actions-programme/ [Accessed 3 April 2024].

19  Te Whatu Ora–Health New Zealand, Te Aka Whai Ora–Māori Health Authority. Comprehensive primary community and rural role description: Practice pharmacist. 2023. Available at https://www.tewhatuora.govt.nz/assets/Whats-happening/What-to-expect/For-the-health-workforce/Primary-community-and-rural/Role-Description-Practice-Pharmacist.pdf [Accessed 20 June 2024].

20  Campbell C, Braund R, Morris C. Beyond the four walls: an exploratory survey of location, employment and roles of pharmacists in primary health care. J Prim Health Care 2017; 9(4): 297-310.
| Crossref | Google Scholar | PubMed |

21  Haua R, Harrison J, Aspden T. Pharmacist integration into general practice in New Zealand. J Prim Health Care 2019; 11(2): 159-69.
| Crossref | Google Scholar | PubMed |

22  Boyina SY, Stokes T, Renall A, et al. Clinical pharmacist facilitators in primary care: a descriptive study of their roles and services provided in general practices of southern New Zealand. J Prim Health Care 2020; 12(1): 88-95.
| Crossref | Google Scholar | PubMed |

23  Royal New Zealand College of General Practitioners. Ngā Kaitaka Rongoā i rō whare tākuta Pharmacists in general practice. 2023. Available at https://www.rnzcgp.org.nz/resources/corporate-documents/pharmacists-in-general-practice-report/ [Accessed 20 June 2024].

24  Qualtrics®. Qualtrics online survey software. 2023. Available at https://www.qualtrics.com/au/core-xm/survey-software/ [Accessed 20 June 2024].

25  Pharmacy Council of New Zealand. Pharmacy workforce demographic 2022. 2022. Available at http://pharmacycouncil.org.nz/wp-content/uploads/2022/10/Workforce-Demographic-Report-2022-Final.pdf [Accessed 20 June 2024].

26  Health New Zealand–Te Whatu Ora. Services to improve access. 2023. Available at https://www.tewhatuora.govt.nz/our-health-system/claims-provider-payments-and-entitlements/services-to-improve-access/#very-low-cost-access-payments [Accessed 20 June 2024].

27  Jeffreys M, Irurzun Lopez M, Russell L, et al. Equity in access to zero-fees and low-cost Primary Health Care in Aotearoa New Zealand: results from repeated waves of the New Zealand Health Survey, 1996-2016. Health Policy 2020; 124(11): 1272-9.
| Crossref | Google Scholar | PubMed |

28  Officer T, Cumming J, McBride-Henry K. Successfully developing advanced practitioner roles: policy and practice mechanisms. J Health Organ Manag 2019; 33(1): 63-77.
| Crossref | Google Scholar | PubMed |

29  Alshehri AA, Cheema E, Yahyouche A, et al. Evaluating the role and integration of general practice pharmacists in England: a cross-sectional study. Int J Clin Pharm 2021; 43(6): 1609-18.
| Crossref | Google Scholar | PubMed |

30  Baker S, Lee YP, Hattingh HL. An evaluation of the role of practice pharmacists in Australia: a mixed methods study. Int J Clin Pharm 2019; 41: 504-15.
| Crossref | Google Scholar | PubMed |

31  Deeks LS, Naunton M, Tay GH, et al. What can pharmacists do in general practice? A pilot trial. Aust J Gen Pract 2018; 47(8): 545-49.
| Crossref | Google Scholar | PubMed |

32  Savickas V, Foreman E, Ladva A, et al. Pharmacy services and role development in UK general practice: a cross‐sectional survey. Int J Pharm Pract 2021; 29(1): 37-44.
| Crossref | Google Scholar | PubMed |

33  Sudeshika T, Deeks LS, Naunton M, et al. Evaluating the potential outcomes of pharmacist-led activities in the Australian general practice setting: a prospective observational study. Int J Clin Pharm 2023; 45: 980-8.
| Crossref | Google Scholar | PubMed |

34  Ridge K. Pharmacist prescribing – professional revolution or damp squib? 2023. Available at https://www.kingsfund.org.uk/blog/2023/04/pharmacist-prescribing-professional-revolution-or-damp-squib [Accessed 20 June 2024].

35  General Pharmaceutical Council. Standards for the education and training of pharmacist independent prescribers. 2022. Available at https://assets.pharmacyregulation.org/files/document/standards-for-the-education-and-training-of-pharmacist-independent-prescribers-october-2022.pdf [Accessed 20 June 2024].

36  Canadian Pharmacists Association – Association des Pharmaciens du Canada. What pharmacists can do across Canada. 2024. Available at https://www.pharmacists.ca/advocacy/scope-of-practice/ [Accessed 20 June 2024].

37  Health New Zealand–Te Whatu Ora. Comprehensive primary and community care teams. 2024. Available at https://www.tewhatuora.govt.nz/health-services-and-programmes/primary-care-development-programme/comprehensive-primary-and-community-care-teams/ [Accessed 20 June 2024].

38  Hurley E, Gleeson LL, Byrne S, et al. General practitioners’ views of pharmacist services in general practice: a qualitative evidence synthesis. Fam Pract 2022; 39(4): 735-46.
| Crossref | Google Scholar | PubMed |

39  Ryan K, Patel N, Lau WM, et al. Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation. BMC Health Serv Res 2018; 18: 234.
| Crossref | Google Scholar | PubMed |

40  Deeks LS, Kosari S, Peterson GM, et al. Factors contributing to pharmacists leaving employment in general practice in Australia: an exploratory study. Int J Pharm Pract 2023; 31(4): 438-41.
| Crossref | Google Scholar | PubMed |

41  Hatah E, Braund R, Duffull SB, et al. General practitioners’ views of pharmacists’ current and potential contributions to medication review and prescribing in New Zealand. J Prim Health Care 2013; 5(3): 223-33.
| Crossref | Google Scholar | PubMed |

42  Jorgenson D, Laubscher T, Lyons B, et al. Integrating pharmacists into primary care teams: barriers and facilitators. Int J Pharm Pract 2014; 22(4): 292-9.
| Crossref | Google Scholar | PubMed |

43  Tan EC, Stewart K, Elliott RA, et al. Stakeholder experiences with general practice pharmacist services: a qualitative study. BMJ Open 2013; 3(9): e003214.
| Crossref | Google Scholar | PubMed |