title: [Cooperation according to French Law "hospital, patients, health and territories": Pharmacists' involvement in Aquitaine region].
abstract: BACKGROUND
  In 2009, the French Act "Hospital, Patients, Health and Territories" (loi "Hôpital, Patients, Santé et Territoires") reorganized the outpatient care pathway and defined missions aimed at improving cooperation between pharmaceutical and medical professionals. Five years later, we conducted a survey among community pharmacists in order to assess the appropriation of these missions and the way cooperation was implemented. We also aimed to investigate factors that could hamper or ease the development of these activities in order to identify actions needed to improve pharmacists' involvement.
  
  
  METHODS
  In partnership with the local health authorities "Agence régionale de santé", we conducted a survey via an online questionnaire sent to pharmacy holders in July 2014 in Aquitaine region. Information was collected about the pharmacies, involvement in collaborative activities, and barriers to cooperation.
  
  
  RESULTS
  Overall, 20% (249) of pharmacists responded to the survey. They owned predominantly rural pharmacies (46%) or neighborhood pharmacies (41%), with two pharmacists per pharmacy (48%). Regarding collaborative activities, the majority of pharmacists (78%) had conducted interviews with their patients taking vitamin K antagonist therapy and they were willing to continue (87%). The implication was less common concerning other actions such as referent pharmacist for nursing homes (19%) or activities relating to therapeutic educational programs for patients with chronic conditions (34%). The vast majority of respondents (85%) were not aware of opportunities to become a correspondent pharmacist. The main obstacles for engaging in these activities were the lack of time, lack of knowledge about these missions and the lack of remuneration. We identified differences in pharmacists' involvement in collaborative activities depending on selected characteristics of the pharmacies.
  
  
  CONCLUSIONS
  The findings of this survey underlined pharmacists' acceptance of these missions and suggest that better information and appropriate remuneration could enhance commitment. Recent changes in the legal framework (establishment of "pharmaceutical fees", extension of the scope of pharmaceutical interviews) enable funding for collaborative practices between medical practitioners and pharmacists, thus encouraging better coordination in the patient care pathway.
authors.affiliation: London School of Hygiene and Tropical Medicine, 15-17, Tavistock Place, London WC1H 9SH, Royaume-Uni. Electronic address: marcdelbee@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: d'Elbée
authors.affiliation: Droit et économie pharmaceutiques, UFR des sciences pharmaceutiques, université de Bordeaux, 33076 Bordeaux, France; Inserm U 1219, santé des populations, pharmaco-épidémiologie et impact des produits de santé sur les populations, 33076 Bordeaux, France.
authors.forename: M
authors.initials: M
authors.lastname: Baumevieille
authors.affiliation: Droit et économie pharmaceutiques, UFR des sciences pharmaceutiques, université de Bordeaux, 33076 Bordeaux, France; Inserm U 1219, santé des populations, pharmaco-épidémiologie et impact des produits de santé sur les populations, 33076 Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Dumartin
mesh_terms: D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D005602:France; D019538:Health Care Surveys; D006761:Hospitals / Q000592:standards; D006801:Humans; D033183:Interdisciplinary Communication; D007885:Legislation, Pharmacy; D010348:Patient Care Team / Q000331:legislation & jurisprudence / Q000458:organization & administration / Q000592:standards; D010361:Patients / Q000331:legislation & jurisprudence; D010595:Pharmacists / Q000331:legislation & jurisprudence*; D055553:Prescription Drugs / Q000627:therapeutic use; D024382:Professional Role; D011369:Professional-Patient Relations; D011634:Public Health / Q000331:legislation & jurisprudence / Q000592:standards
chemical_list: D055553:Prescription Drugs
keywords: Enquête sur les services de santé; Health care survey; Parcours de soins coordonnés; Partnership practice; Pharmacies; Pharmacist; Public health; Santé publique