title: An analysis of inter-professional collaboration in osteoporosis screening at a primary care level using the D'Amour model.
abstract: This study describes the perspective of patients, nurses, pharmacists, doctors and policy makers to identify the level of collaboration and the areas for improvement to achieve inter-professional collaboration between doctors, nurses, pharmacists and policy makers in a primary care clinic.
  
  
  
  Patients (n = 20), Nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) from a primary care were individually interviewed using a semi-structured topic guide. Purposive sampling was used. Interviews were transcribed verbatim and analysed using thematic analysis informed by constant comparison.
  
  
  
  Patients, doctors, nurses, pharmacists and policy makers were eager for pharmacists to be more proactive in creating health awareness and conducting osteoporosis screening at the primary care clinic via inter-professional collaboration. These findings were further examined using the D'Amour's structural model of collaboration which encompasses four main themes: shared goals and visions, internalization, formalization and governance. This model supports our data which highlights a lack of understanding of the pharmacists' role among the doctors, nurses, policy makers and pharmacists themselves. There is also a lack of governance and formalization, that fosters consensus, leadership, protocol and information exchange. Nonetheless, the stakeholders trust that pharmacists have sufficient knowledge to contribute to the screening of osteoporosis. Our primary care clinic can be described as developing towards an inter-professional collaboration in managing osteoporosis but is still in its early stages.
  
  
  
  Inter-professional collaboration in osteoporosis management at the primary care level is beginning to be practised. Efforts extending to awareness and acceptance towards the pharmacists' role will be crucial for a successful change.
authors: Division of Pharmacy, School of Medicine, University of Tasmania, Sandy Bay Campus, Pharmacy Building, Churchill Avenue, 7005, Australia.
authors: L S
authors: LS
authors: Toh
authors: Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors: P S M
authors: PSM
authors: Lai
authors: Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia.
authors: S
authors: S
authors: Othman
authors: School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
authors: K T
authors: KT
authors: Wong
authors: School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
authors: B Y
authors: BY
authors: Low
authors: Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, NG7 2RD, UK. Electronic address: Claire.Anderson@nottingham.ac.uk.
authors: C
authors: C
authors: Anderson
mesh_terms: D000288:Administrative Personnel; D000368:Aged; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008875:Middle Aged; D017146:Models, Organizational; D009726:Nurses; D010024:Osteoporosis / Q000175:diagnosis*; D010595:Pharmacists; D010820:Physicians; D011320:Primary Health Care; D024382:Professional Role
keywords: Inter-professional collaboration; Osteoporosis; Pharmacists; Primary care; Screening