General practitioner perceptions of clinical medication reviews undertaken by community pharmacists.
BACKGROUND
Delivery of current health care services focuses on interdisciplinary teams and greater involvement of health care providers such as nurses and pharmacists. This requires a change in role perception and acceptance, usually with some resistance to changes. There are few studies investigating the perceptions of general practitioners (GPs) towards community pharmacists increasing their participation in roles such as clinical medication reviews. There is an expectation that these roles may be perceived as crossing a clinical boundary between the work of the GP and that of a pharmacist.


METHODS
Thirty-eight GPs who participated in the General Practitioner-Pharmacists Collaboration (GPPC) study in New Zealand were interviewed at the study conclusion. The GPPC study investigated outcomes of a community pharmacist undertaking a clinical medication review in collaboration with a GP, and potential barriers. The GPs were exposed to one of 20 study pharmacists. The semi-structured interviews were recorded and transcribed verbatim then analysed using a general inductive thematic approach.


RESULTS
The GP balanced two themes, patient outcomes and resource utilisation, which determined the over-arching theme, value. This concept was a continuum, depending on the balance. Factors influencing the theme of patient outcomes included the clinical versus theoretical nature of the pharmacist recommendations. Factors influencing resource utilisation for general practice were primarily time and funding.


CONCLUSIONS
GPs attributed different values to community pharmacists undertaking clinical medication reviews, but this value usually balanced the quality and usefulness of the pharmacist's recommendations with the efficiency of the system in terms of workload and funding.
Department of General Practice and Primary Health Care, The University of Auckland, PB 92019 Auckland, New Zealand. linda@cpsl.biz
Linda
L
Bryant
Gregor
G
Coster
Ross
R
McCormick
D000328:Adult; D001291:Attitude of Health Personnel; D003157:Community Pharmacy Services; D017723:Drug Utilization Review; D005260:Female; D058005:General Practitioners; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D024382:Professional Role