The role of clinical pharmacists in general practice in England: Impact,perspectives, barriers and facilitators |
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| Institution: | 1. Washington State University College of Pharmacy and Pharmaceutical Sciences, USA;2. Nelson Mandela University Department of Pharmacy, South Africa;3. Danish Association of Pharmacy Technicians, Denmark;4. University of the Philippines Manila, Philippines;5. Cambridge University Hospitals NHS Foundation Trust, UK;6. Pharmprogress Armenian Pharmacists Association, Armenia;7. International Pharmaceutical Federation (FIP), Workforce Lebanese International University School of Pharmacy, the Netherlands;8. Touro University California College of Pharmacy, USA;9. International Pharmaceutical Federation (FIP), Workforce Transformation and Development, the Netherlands;10. International Pharmaceutical Federation (FIP), Global Pharmacy Observatory, the Netherlands;11. International Pharmaceutical Federation (FIP), Pharmacy Technician Advisory Committee, the Netherlands;1. Phymedexp, University of Montpellier, Inserm, CNRS, CHRU de Montpellier, 191 Avenue du Doyen Giraud, 34295, Montpellier cedex 5, France;2. Research Center on Aging, CIUSSS de l’Estrie-CHUS, 1036 Rue Belvédère Sud, Sherbrooke, Québec, J1H 4C4, Canada;3. Faculty of Pharmacy, University of Montreal, C.P. 6128, succursale Centre-ville, Montréal, Québec, H3C 3J7, Canada;4. Department of Pharmacy, McGill University Health Centre, 1001 Boulevard Décarie, Montréal, Québec, H4A 3J1, Canada;5. Faculty of Medicine and Health Sciences, University of Sherbrooke, 3001 12 Ave N Immeuble X1, Sherbrooke, Québec, J1H 5N4, Canada;6. Department of Medicine, CIUSSS de l’Estrie-CHUS, 3001 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada;7. Faculty of Letters and Human Sciences, University of Sherbrooke, 2500 Boulevard de l’Université, Sherbrooke, Québec, J1K 2R1, Canada;8. Faculty of Pharmacy, Laval University, 1050 Avenue de la Médecine, Québec, G1V 0A6, Canada;9. Department of Pharmacy, CIUSSS de l’Estrie-CHUS, 3001 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4, Canada;1. School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Private Bag 26, Hobart, Tasmania, 7001, Australia;2. Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, Tasmania, 7001, Australia;3. Royal Hobart Hospital, GPO Box 1061, Hobart, Tasmania, 7001, Australia;1. Palmerston North Hospital Pharmacy, MidCentral District Health Board, Palmerston North, New Zealand;2. School of Pharmacy, University of Otago, Dunedin, New Zealand;3. New Zealand Pharmacovigilance Centre, University of Otago, Dunedin, New Zealand |
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| Abstract: | BackgroundBy 2020/1 NHS England plans to invest over 100 m to ensure that there is one clinical pharmacist post in primary care for every 30,000 patients. A recent realist review identified key questions in the literature related to the implementation of a clinical pharmacist (CP) in a general practice role. These relate to the impact of the role, perspectives on the role (patients, GPs and pharmacists), and barriers and facilitators to the implementation process. The data collected in the national evaluation of the pilot scheme provides data to answer the realist questions identified.ObjectivesThis paper examines the experience of implementing the clinical pharmacist in general practice role, in relation to the areas identified above.MethodsThe research took a mixed methods approach to understanding the scheme implementation and this research draws on both survey and qualitative interview data from a wide range of stakeholders.ResultsPharmacists in the pilot phase are motivated to develop clinical skills and make a positive impact on patients. Data suggests that clinical pharmacists have a positive impact, in particular on health outcomes related to polypharmacy and long-term conditions. GPs have a broadly positive response to the CPs, in particular when they save time and money for the practice. However, GPs have to invest time in mentoring and building relationships to realise the benefits of the role. Patients appreciate the CP role for increasing access to a practitioner and providing expertise in medications. There are some barriers to successful implementation of the role, including policy and funding, lack of clarity around the role and lack of quantitative and economic validation of the role. Facilitators of success include supportive working relationships, integration and mentoring.ConclusionThe pilot implementation of this new role was successful but there are lessons which can be learned for the success of future iterations and more work is required to economically validate the role which is likely to in turn generate positive relationships with GPs. |
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| Keywords: | Pharmacist Clinical pharmacist General practice Primary care Patients |
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