RT Journal Article
SR Electronic
T1 Patient, family physician and community pharmacist perspectives on expanded pharmacy scope of practice: a qualitative study
JF CMAJ Open
FD Canadian Medical Association
SP E205
OP E212
DO 10.9778/cmajo.20160135
VO 5
IS 1
A1 Maoliosa Donald
A1 Kathryn King-Shier
A1 Ross T. Tsuyuki
A1 Yazid N. Al Hamarneh
A1 Charlotte A. Jones
A1 Braden Manns
A1 Marcello Tonelli
A1 Wendy Tink
A1 Nairne Scott-Douglas
A1 Brenda R. Hemmelgarn
YR 2017
UL http://www.cmajopen.ca/content/5/1/E205.abstract
AB Background: The RxEACH trial was a randomized trial to evaluate the efficacy of community pharmacy-based case finding and intervention in patients at high risk for cardiovascular (CV) events. Community-dwelling patients with poorly controlled risk factors were identified and their CV risk reduced through patient education, prescribing and follow-up by their pharmacist. Perspectives of patients, family physicians and community pharmacists were obtained regarding pharmacists' identification and management of patients at high risk for CV events, to identify strategies to facilitate implementation of the pharmacist's expanded role in routine patient care.Methods: We used a qualitative methodology (individual semistructured interviews) with conventional qualitative content analysis to describe perceptions about community pharmacists' care of patients at high risk for CV events. Perceptions were categorized into macro (structure), meso (institution) and micro (practice) health system levels, based on a conceptual framework of care for optimizing scopes of practice.Results: We interviewed 48 participants (14 patients, 13 family physicians and 21 community pharmacists). Patients were supportive of the expanded scope of practice of pharmacists. All participant groups emphasized the importance of communication, ability to share patient information, trust and better understanding of the roles, responsibilities, accountabilities and liabilities of the pharmacist within their expanded role.Interpretation: Despite support from patients and changes to delivery of care in primary care settings, ongoing efforts are needed to understand how to best harmonize family physician and community pharmacist roles across the health system. This will require collaboration and input from professional associations, regulatory bodies, pharmacists, family physicians and patients.