International Journal of Clinical Pharmacy

, Volume 39, Issue 3, pp 495–506 | Cite as

Interprofessional communication between community pharmacists and general practitioners: a qualitative study

  • Marina Weissenborn
  • Walter E. Haefeli
  • Frank Peters-Klimm
  • Hanna M. SeidlingEmail author
Research Article


Background While collaboration between community pharmacists (CPs) and general practitioners (GPs) is essential to provide comprehensive patient care, their communication often is scarce and hampered by multiple barriers. Objective We aimed to assess both professions’ perceptions of interprofessional communication with regard to content and methods of communication as a basis to subsequently develop best-practice recommendations for information exchange. Setting Ambulatory care setting in Germany. Method CPs and GPs shared their experience in focus groups and in-depth interviews which were conducted using a semi-structured interview guideline. Transcribed recordings were assessed using qualitative content analysis according to Mayring. Main outcome measure Specification of existing barriers, CPs’/GPs’ general perceptions of interprofessional communication and similarities and differences regarding prioritization of specific information items and how to best communicate with each other. Results Four focus groups and fourteen interviews were conducted. Seven internal (e.g. professions were not personally known to one another) and nine external barriers (e.g. mutual accessibility) were identified. Ten organizational, eight medication-related, and four patient-related information items were identified requiring interprofessional communication. Their relevance varied between the professions, e.g. CPs rated organizational issues higher than GPs. Both professions indicated communication via phone to be the most frequently used method of communication. Conclusion CPs and GPs opinions often differ. However, communication between CPs and GPs is perceived as crucial suggesting that a future concept has to offer standardized recommendations, while leaving CPs and GPs room to adjust it to their individual needs.


Community pharmacist General practitioner Germany Focus groups Interprofessional communication Qualitative research 



We thank all GPs and CPs for participation in our study, Dr. Cornelia Mahler and Dr. Alexander Send for English language editing and Lisa Kohl, Lisa Veitinger, and Daniela Tschada for compiling the initial transcript of the FG and the IDI.


The Department of Clinical Pharmacology and Pharmacoepidemiology received financial funding from “Förderinitiative Pharmazeutische Betreuung e.V. (Berlin, Germany)”. The funding had no influence on the conduct of the study, the analysis and interpretation of the data and the writing of the manuscript.

Conflicts of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    The World Medical Association, INC. WMA statement on the relationship between physicians and pharmacists in medical therapy. 2010. Accessed 17 May 2016.
  2. 2.
    Hirsch JD, Steers N, Adler DS, Kuo GM, Morello CM, Lang M, Singh RF, Wood Y, Kaplan RM, Mangione CM. Primary care-based, pharmacist–physician collaborative medication-therapy management of hypertension: a randomized, pragmatic trial. Clin Ther. 2014;36:1244–54.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Michot P, Catala O, Supper I, Boulieu R, Zerbib Y, Colin C, Letrilliart L. Cooperation between general practitioners and pharmacists: a systematic review. Sante Publique. 2013;25:331–41.PubMedGoogle Scholar
  4. 4.
    Carter BL, Bergus GR, Dawson JD, Farris KB, Doucette WR, Chrischilles EA, Hartz AJ. A cluster randomized trial to evaluate physician/pharmacist collaboration to improve blood pressure control. J Clin Hypertens (Greenwich). 2008;10:260–71.CrossRefGoogle Scholar
  5. 5.
    Bardet JD, Vo TH, Bedouch P, Allenet B. Physicians and community pharmacists collaboration in primary care: a review of specific models. Res Soc Adm Pharm. 2015;11:602–22.CrossRefGoogle Scholar
  6. 6.
    McDonough RP, Doucette WR. Developing collaborative working relationships between pharmacists and physicians. J Am Pharm Assoc. 2001;41:682–92.CrossRefGoogle Scholar
  7. 7.
    Zillich AJ, Doucette WR, Carter BL, Kreiter CD. Development and initial validation of an instrument to measure physician–pharmacist collaboration from the physician perspective. Value Health. 2005;8:59–66.CrossRefPubMedGoogle Scholar
  8. 8.
    Doucette WR, Nevins J, McDonough RP. Factors affecting collaborative care between pharmacists and physicians. Res Socl Adm Pharm. 2005;1:565–78.CrossRefGoogle Scholar
  9. 9.
    Dey RM, de Vries MJ, Bosnic-Anticevich S. Collaboration in chronic care: unpacking the relationship of pharmacists and general medical practitioners in primary care. Int J Pharm Pract. 2011;19:21–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Bradley F, Ashcroft DM, Noyce PR. Integration and differentiation: a conceptual model of general practitioner and community pharmacist collaboration. Res Soc Adm Pharm. 2012;8:36–46.CrossRefGoogle Scholar
  11. 11.
    Van C, Costa D, Abbott P, Mitchell B, Krass I. Community pharmacist attitudes towards collaboration with general practitioners: development and validation of a measure and a model. BMC Health Serv Res. 2012;12:320.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Zillich AJ, McDonough RP, Carter BL, Doucette WR. Influential characteristics of physician/pharmacist collaborative relationships. Ann Pharmacother. 2004;38:764–70.CrossRefPubMedGoogle Scholar
  13. 13.
    Snyder ME, Zillich AJ, Primack BA, Rice KR, Somma McGivney MA, Pringle JL, Smith RB. Exploring successful community pharmacist–physician collaborative working relationships using mixed methods. Res Soc Adm Pharm. 2010;6:307–23.CrossRefGoogle Scholar
  14. 14.
    Liu Y, Doucette WR, Farris KB. Examining the development of pharmacist-physician collaboration over 3 months. Res Soc Adm Pharm. 2010;6:324–33.CrossRefGoogle Scholar
  15. 15.
    Muijrers PE, Knottnerus JA, Sijbrandij J, Janknegt R, Grol RP. Changing relationships: attitudes and opinions of general practitioners and pharmacists regarding the role of the community pharmacist. Pharm World Sci. 2003;25:235–41.CrossRefPubMedGoogle Scholar
  16. 16.
    ARMIN Project. Accessed 4 April 2016.
  17. 17.
    ARMIN Project (engl). Accessed 30 Sept 2016.
  18. 18.
    ABDA (Bundesvereinigung deutscher Apothekerverbände e.V.). Pilot project: Ambulatory detoxification of patients being addicted to benzodiazepines with cooperation between pharmacists and general practitioners. 2013. Accessed 29 April 2016.
  19. 19.
    Farland MZ, Byrd DC, McFarland MS, Thomas J, Franks AS, George CM, Gross BN, Guirguis AB, Suda KJ. Pharmacist–physician collaboration for diabetes care: the diabetes initiative program. Ann Pharmacother. 2013;47:781–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Rodgers J, Walker R. Medicines use reviews: what they are for and how to make use of them. Br J Community Nurs. 2007;12:563–5.CrossRefPubMedGoogle Scholar
  21. 21.
    National Health Service. Guidance on the Medicines Use Review (MUR) service. 2013. Accessed 17 May 2016.
  22. 22.
    Costa D, Van C, Abbott P, Krass I. Investigating general practitioner engagement with pharmacists in Home Medicines Review. J Interprof Care. 2015;29:469–75.CrossRefPubMedGoogle Scholar
  23. 23.
    Pharmaceutical Society of Australia. Guidelines for pharmacists providing Home Medicines Review (HMR) services. 2011. Accessed 17 May 2016.
  24. 24.
    Pharm-CHF Trial. Accessed 30 Sept 2016.
  25. 25.
    McGrath SH, Snyder ME, Dueñas GG, Pringle JL, Smith RB, McGivney MS. Physician perceptions of pharmacist-provided medication therapy management: qualitative analysis. J Am Pharm Assoc. 2003;2010(50):67–71.Google Scholar
  26. 26.
    Kelly DV, Bishop L, Young S, Hawboldt J, Phillips L, Keough TM. Pharmacist and physician views on collaborative practice: Findings from the community pharmaceutical care project. Can Pharm J (Ott). 2013;146:218–26.CrossRefGoogle Scholar
  27. 27.
    Hughes CM, McCann S. Perceived interprofessional barriers between community pharmacists and general practitioners: a qualitative assessment. Br J Gen Pract. 2003;53:600–6.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19:349–57.CrossRefPubMedGoogle Scholar
  29. 29.
    Dresing T, Pehl T. Praxisbuch interview & transcription. 4th ed. Marburg: Eigenverlag; 2012.Google Scholar
  30. 30.
    Mayring P. Qualitative Inhaltsanalyse. Grundlagen und Techniken. 11th ed. Weinheim: Beltz Verlag; 2010.Google Scholar
  31. 31.
    Wilkinson D, Birmingham P. Using research instruments—a guide for researchers. London: RoutledgeFalmer; 2003.CrossRefGoogle Scholar
  32. 32.
    Kitzinger J. Qualitative research. Introducing focus groups. BMJ. 1995;311:299–302.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Headrick LA, Khaleel NI. Getting it right: educating professionals to work together in improving health and health care. J Interprof Care. 2008;22:364–74.CrossRefPubMedGoogle Scholar
  34. 34.
    Greene RJ, Cavell GF, Jackson SH. Interprofessional clinical education of medical and pharmacy students. Med Educ. 1996;30:129–33.CrossRefPubMedGoogle Scholar
  35. 35.
    Bridges DR, Davidson RA, Odegard PS, Maki IV, Tomkowiak J. Interprofessional collaboration: three best practice models of interprofessional education. Med Educ Online. 2011;16:1–10.Google Scholar
  36. 36.
    Thom KA, Heil EL, Croft LD, Duffy A, Morgan DJ, Johantgen M. Advancing interprofessional patient safety education for medical, nursing, and pharmacy learners during clinical rotations. J Interprof Care. 2016;30:819–22.Google Scholar
  37. 37.
    Horsburgh M, Lamdin R, Williamson E. Multiprofessional learning: the attitudes of medical, nursing and pharmacy students to shared learning. Med Educ. 2001;35:876–83.CrossRefPubMedGoogle Scholar
  38. 38.
    Hawkes G, Nunney I, Lindqvist S. Caring for attitudes as a means of caring for patients–improving medical, pharmacy and nursing students’ attitudes to each other’s professions by engaging them in interprofessional learning. Med Teach. 2013;35:e1302–8.CrossRefPubMedGoogle Scholar
  39. 39.
    Dienst ER, Byl N. Evaluation of an educational program in health care teams. J Community Health. 1981;6:282–98.CrossRefPubMedGoogle Scholar
  40. 40.
    Wilson AJ, Palmer L, Levett-Jones T, Gilligan C, Outram S. Interprofessional collaborative practice for medication safety: nursing, pharmacy, and medical graduates’ experiences and perspectives. J Interprof Care. 2016;30:649–54.CrossRefPubMedGoogle Scholar
  41. 41.
    Gilligan C, Outram S, Levett-Jones T. Recommendations from recent graduates in medicine, nursing and pharmacy on improving interprofessional education in university programs: a qualitative study. BMC Med Educ. 2014;14:52.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Bugnon O, Jotterand S, Niquille Charrière A, Ruggli M, Herzig L. Physicians-pharmacists quality circles: shared responsibility of the freedom of prescription. Rev Med Suisse. 2012;8:1044–8.Google Scholar
  43. 43.
    Niquille A, Ruggli M, Buchmann M, Jordan D, Bugnon O. The nine-year sustained cost-containment impact of swiss pilot physicians-pharmacists quality circles. Ann Pharmacother. 2010;44:650–7.CrossRefPubMedGoogle Scholar
  44. 44.
    Urologisches Netzwerk Bonn e.V.: Qualitätszirkel. Accessed 7 Sept 2016.
  45. 45.
    Linn LS, Davis MS. Occupational orientation and overt behavior—the pharmacist as drug adviser to patients. Am J Public Health. 1973;63:502–8.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Rieck A, Pettigrew S. How physician and community pharmacist perceptions of the community pharmacist role in Australian primary care influence the quality of collaborative chronic disease management. Qual Prim Care. 2013;21:105–11.PubMedGoogle Scholar
  47. 47.
    Choi BC, Pak AW. A catalog of biases in questionnaires. Prev Chronic Dis. 2005;2:A13.PubMedGoogle Scholar
  48. 48.
    Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Marina Weissenborn
    • 1
  • Walter E. Haefeli
    • 1
  • Frank Peters-Klimm
    • 2
  • Hanna M. Seidling
    • 1
    Email author
  1. 1.Department of Clinical Pharmacology and Pharmacoepidemiology, Cooperation Unit Clinical PharmacyUniversity of HeidelbergHeidelbergGermany
  2. 2.Department of General Practice and Health Services ResearchHeidelberg University HospitalHeidelbergGermany

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