Integration of community pharmacy in primary health care: The challenge |
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| Affiliation: | 1. Pharmaceutical Care Research Group, University of Granada, Granada, Spain;2. Pharmacy Practice Research Group, Faculty of Pharmacy, University of the Basque Country, UPV/EHU, Vitoria-Gasteiz, Spain;3. Center for Health Technology and Services Research (CINTESIS), Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal;4. Graduate School of Health, University of Technology Sydney, Sydney, Australia;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. 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;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, Faculty of Medicine and Health & Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia;2. Menzies Centre for Health Policy, School of Public Health, Faculty of Medicine and Health & Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia;3. Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO, USA;1. Faculty of Medicine, Dalhousie University, 5849 University Ave, Halifax, NS, Canada;2. College of Pharmacy, Dalhousie University, 5968 College Street, Halifax, NS, Canada;3. Quality Use of Medicines and Pharmacy Research Centre, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia;4. Geriatric Medicine Research, Faculty of Medicine, Dalhousie University and Nova Scotia Health Authority, Halifax, NS, Canada;5. School of Nursing, Dalhousie University, 5869 University Avenue, Halifax, NS, Canada;6. Pharmacy Department, Nova Scotia Health Authority, Halifax, NS, Canada;1. Department of Clinical Pharmacy, Jan Tooropstraat 164, 1061AE, Amsterdam, the Netherlands;2. Amsterdam UMC, Location Vumc, Department of Clinical Pharmacology and Pharmacy, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands;3. Erasmus MC, University Medical Center Rotterdam, Department of Hospital Pharmacy. University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Groningen, the Netherlands;4. Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands;5. Department of Pharmacy, Radboud University Medical Centre, Nijmegen, 6525 GA, the Netherlands |
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| Abstract: | Community pharmacies and pharmacists predominantly operate in a retail environment independently of other health care providers, and they are not often viewed as an integral member of the healthcare team. Thus, they remain overlooked or excluded during integration processes of health care systems. At the same time, there are calls by the profession at national and international levels for community pharmacy to be integrated within primary care systems. The COVID-19 pandemic appears to have further stimulated this desire. When pressing for integration, various terms, such as integration, integrated care, or interprofessional collaboration, are used in an interchangeable manner leading to lack of clarity, ambiguity and confusion for health care policy makers, planners, and other healthcare professionals. The literature was reviewed to identify critical components for community pharmacy to consider for integration. From the five selected articles describing integration of community pharmacies, four different constructs were identified: consensus, connectivity, communication and trust. The integration of community pharmacy into the health system may translate into better access for patients to primary care services, contribute to cost effectiveness, and promulgate the sustainability of the system. However significant political, economic, social, and practice change would be required by all stakeholders. Further research is needed to underpin a consensus for a definition, the type of integration, and the model optimally suited to integrate community pharmacy into primary care. These models, specific and adaptable to each national health care system and political environment, would need to be consensus-based by principal stakeholders to overcome a variety of barriers, including government resistance. Mere calls or demands by the pharmaceutical profession, although laudable, will not be sufficient to overcome the historical, cultural, and economic challenges. |
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| Keywords: | Community pharmacy Pharmacists Integration Systems integration Primary care |
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