Community pharmacist perceptions of clinical medication reviews

Abstract

INTRODUCTION: Changes in delivery of health care services has led to pressure for community pharmacists to extend their traditional role and become more involved with patient-focussed services such as medication reviews, in collaboration with general practitioners (GPs). This has not been generally implemented into routine practice, and many barriers have been suggested that inhibit community pharmacists extending their role. These have often focussed on physical or functional barriers. This study explores possible attitudinal factors that prevent increased participation of community pharmacists in medication reviews undertaken in collaboration with GPs. METHODS: Twenty community pharmacist participants who participated in the General Practitioner– Pharmacist Collaboration (GPPC) study were interviewed. The GPPC study investigated the outcomes of community pharmacists undertaking a clinical medication review in collaboration with GPs, and the potential barriers. Semi-structured interviews were analysed using a general inductive thematic approach. FINDINGS: Emerging themes were that community pharmacists perceived that they were not mandated to undertake this role, it was not a legitimate role, particularly from the business perceptive, and pharmacists were concerned that they lacked the skills and confidence to provide this level of input. CONCLUSION: While there is concern that community pharmacists’ skills are underutilised, there are probable attitudinal barriers inhibiting pharmacists from increasing their role in clinical medication reviews. Perceived legitimacy of the service was a dominant theme, which appeared to be related to issues in the business model. Further investigation should consider the use of a clinical pharmacist working within a general practice independent of a community pharmacy. KEYWORDS: Community pharmacy services; drug utilization review; primary healthcare; health plan implementation