Expanding the clinical role of community pharmacy: A qualitative ethnographic study of medication reviews in Ontario,Canada |
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| Affiliation: | 1. Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario, M5T 3M6, Canada;2. Toronto Health Economics and Technology Assessment (THETA) Collaborative, Toronto General (Hospital) Research Institute, University Health Network, 200 Elizabeth Street, 10th Floor, Toronto, Ontario, M5G 2C4, Canada;3. Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario, M5S 3M2, Canada;1. Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Phyathai Road, Pathumwan, Bangkok, Thailand;2. Pharmacy Unit, Klang Hospital, Bangkok, Thailand;1. Division of Pharmaceutical Evaluation & Policy, University of Arkansas for Medical Sciences, Little Rock, AR, USA;2. Competitive Health Analytics, Inc., Humana, Louisville, KY, USA;3. Department of Pharmacy Practice, University of Kentucky College of Pharmacy, Lexington, KY, USA;1. Curriculum and New Programs, MCPHS University, 19 Foster Street, Worcester, MA 01608, United States;2. MCPHS University, 19 Foster Street, Worcester, MA 01608, United States;3. MCPHS University, 1260 Elm Street, Manchester, NH 03101, United States;4. School of Pharmacy, MCPHS University, 19 Foster Street, Worcester, MA 01608, United States;5. School of Pharmacy, MCPHS University, 19 Foster Street, Worcester, MA 01608, United States;6. William Carey University, 498 Tuscan Avenue, Hattiesburg, MS 39401, United States |
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| Abstract: | ![]()
Medication reviews by community pharmacists are an increasingly common strategy to improve medication management for chronic conditions, and are part of wider efforts to make more effective use of community-based health professionals. To identify opportunities to optimize the medication review program in Ontario, Canada, we explored how providers and clients interpret and operationalize medication reviews within everyday community pharmacy practice. We conducted a qualitative ethnographic study at four pharmacies in Ontario, Canada, including non-participant observation of provider and client activities and interactions with specific attention to medication reviews, as well as brief ethnographic interviews with providers and clients, and in-depth, semi-structured interviews with providers. We report on 72 h of field research, observation of 178 routine pharmacist-client interactions and 29 medication reviews, 62 brief ethnographic interviews with providers and clients, and 7 in-depth, semi-structured interviews with providers. We found that medication reviews were variably conducted across the dimensions of duration, provider type, location, and interaction style, and that local contexts and system-wide developments influence their meaning and practice. Medication reviews are exemplary of policy efforts to enhance the role of community pharmacies within health systems and the scope of practice of pharmacists as healthcare professionals. Our study highlights the importance of the local structure of community pharmacy practice and the clinical aspirations of pharmacists in the delivery of medication reviews. |
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| Keywords: | Medication reviews Community pharmacy Health policy |
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