General practitioners’ perceptions of pharmacists’ new services in New Zealand
Background In recent years, the pharmacy profession has moved towards more patient-oriented services. Some examples are medication review, screening and monitoring for disease, and prescribing. The new services are intended to be in close collaboration with general practitioners (GPs) yet little is known of how GPs in New Zealand perceive these new services. Objective To examine GPs’ perceptions of pharmacists’ new services. Setting Study was undertaken at GPs’ practices in two localities in New Zealand. Methods Qualitative, face to face, semi-structured interviews were undertaken of 18 GPs. The cohort included GPs with less/more than 20 years of practice, and GPs who had experience of working in localities where some patients had undergone a medication review (Medicines Use Review, MUR) by community pharmacists. GPs were asked to share their perceptions about pharmacists providing some new services. Data were thematically analysed with constant comparison using NVivo 8 software. Using a business strategic planning approach, themes were further analysed and interpreted as the services’ potential Strengths, Weaknesses, Opportunities and Threats (SWOTs). Main outcomes measure GPs’ perceptions of pharmacists’ new services. Results GPs were more supportive of pharmacists’ playing active roles in medication review and less supportive of pharmacists practising screening-monitoring and prescribing. Discussions Pharmacists’ knowledge and skills in medication use and the perceived benefits of the services to patients were considered the potential strengths of the services. Weaknesses centred around potential patient confusion and harm, conflict and irritation to GPs’ practice, and the potential to fragment patient-care. Opportunities were the possibilities of improving communication, and having a close collaboration and integration with GPs’ practice. Apparent threats were the GPs’ perceptions of a related, and not renumerated, increase in their workloads, and the perception of limited benefit to patients. Conclusion Pharmacists should exploit their own strengths and the potential opportunities for these services, and reduce any weaknesses and threats. A possible strategic plan should include increased effective communication, piloting services, and the integration of some services into medical practices.
KeywordsCommunity pharmacy services General practitioners Perceptions Pharmacists New Zealand
We would like to thank the GPs who took part in this study and the community pharmacists who helped us identify the GPs whose patients had undergone a MUR.
Funding for this study was provided by the School of Pharmacy, University of Otago.
Conflicts of interest
None to declare.
- 1.Pharmaceutical Services Negotiating Committee (PSNC). About community pharmacy. [cited 2011 4th August]; Available from: http://www.psnc.org.uk/pages/about_community_pharmacy.html.
- 2.Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. Washington, DC: National Academy Press; 2000.Google Scholar
- 3.Parlimentary Office of Sciene and Technology Postnote Number 248. Changing role of pharmacies. 2005 [cited 2011 4th August]; Available from: http://www.parliament.uk/documents/post/postpn246.pdf.
- 4.Youssef S. Medicines use reviews. London: Pharmaceutical Press; 2010.Google Scholar
- 5.Clyne W, Blenkinsopp A, Seal R. A guide to medication review. 2008; Available from: http://www.npc.nhs.uk/review_medicines/intro/resources/agtmr_web1.pdf.
- 6.Roughead EE, Barratt JD, Ramsay E, Pratt N, Ryan P, Peck R, Killer G, Gilbert AL. The effectiveness of collaborative medicine reviews in delaying time to next hospitalization for patients with heart failure in the practice setting: results of a cohort study. Circ Heart Fail. 2009;2(5):424.PubMedCrossRefGoogle Scholar
- 10.Pharmacy Council of New Zealand. Consultation document: proposed pharmacist prescriber scope of practice. [cited 2011 4th August]; Available from: http://www.pharmacycouncil.org.nz/cms_show_download.php?id=192.
- 11.National Prescribing Centre (NPC). Non-medical prescribing. [cited 2011 4th August]; Available from: http://www.npc.nhs.uk/non_medical/.
- 12.Department of Medicines Policy (WHO) and Standards and International Pharmaceutical Federation. Developing pharmacy practice, a focus on patient-care. 2006 [cited 2011 4th August]; Available from: http://www.fip.org/files/fip/publications/DevelopingPharmacyPractice/DevelopingPharmacyPracticeEN.pdf.
- 13.Pharmacy Council of New Zealand. Medicines management: Definition, levels, competence framework. 2006 [cited 2011 14th August]; Available from: http://www.pharmacycouncil.org.nz/cms_show_download.php?id=124.
- 14.Lee E, Braund R, Tordoff J. Examining the first year of medicines use review services provided by pharmacist in New ZEaland:2008. N Z Med J. 2009;122(1293):26–35.Google Scholar
- 15.District Health Board New Zealand (DHBNZ). New Zealand National Pharmacy Services Framework. [cited Oct 2011; Available from: http://www.dhbnz.org.nz/Site/SIG/NPSF/default.aspx.
- 16.Buckley P, Grime J, Blenkinsopp A. Factors enabling or inhibiting the implementation of pharmacist prescribing in secondary care. Int J Pharm Pract. 2008;Suppl 1:A7–A8.Google Scholar
- 19.Van C, Krass I, Mitchell B. General practitioner perceptions of extended pharmacy services and modes of collaboration with pharmacists. J Pharm Pract Res. 2007;37(3):182–6.Google Scholar
- 21.Ranelli P, Biss J. Physicians’ perceptions of communication with and responsibilities of pharmacists. J Am Pharm Assoc (Wash). 2000;40(5):625–30.Google Scholar
- 24.Department of Health & Ageing and Medication Management & Research Section. Home medicines review program qualitative research project final report. 2008 [cited 2010 15 March]; Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/B2992EBF12BE7E1ECA2573D8007F91F3/$File/HMR%20Final%20Report.pdf.
- 26.Schulz R, Johnson AC. Management of hospitals and health services: strategic issues and performance. 3rd ed. United States of America: C.V. Mosby Company; 1990.Google Scholar
- 29.Bradley F, Elvey R, Ashroft DM, Hassell K, Kendall J, Sibbald B, Noyce P. The challenge of intergrating community pharmacists into the primary health care team: a case study of local pharmaceutical services (LPS) pilots and interprofessional collaboration. J Interprof Care. 2008;22(4):387–98.PubMedCrossRefGoogle Scholar
- 32.Bryant L. General practitioner perceptions of clinical medication reviews undertaken by community pharmacists. Primary Health Care. 2010;2(3):225–33.Google Scholar
- 34.Rigby D. Collaboration between doctors and pharmacists in the community. Aust Prescr. 2010;33:191–3.Google Scholar