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Building the evidence for the impact of pharmacists in general practice: a multi-method, realistic study
Background: There has recently been a drive to integrate pharmacists into UK
general practices to tackle workload pressures and enhance patient access to
healthcare. Although not a new role, it is the first time that pharmacist presence in
general practice is being formally funded and tested. Therefore, little is known about
how pharmacists in general practices impact the wider healthcare system.
Aim: To build evidence on the impact of pharmacists in general practice, via in-depth
elicitation of stakeholder experiences.
Methods: A multi-method, ‘realistic’ approach was followed, including qualitative
focus groups with general practice-based staff to identify impact measurement
problems for pharmacists in general practice; an e-Delphi study to reach consensus,
amongst experts, on what pharmacist activities are important to record as part of
impact identification; and qualitative interviews with community pharmacy teams and
patients to explore their experiences of general practice-based pharmacists. Focus
groups and interviews were audio-recorded and transcribed verbatim. Qualitative
data was analysed thematically and quantitative data via descriptive statistics.
Results: Pharmacists carry out various valuable services in general practice,
however, the majority of existing national measures are not fit for purpose in
targeting pharmacist work and capturing the whole spectrum and quality of services.
There was agreement on recording primarily funding-related activities, which
included medication reviews, high-risk drug monitoring and medicines
reconciliations. Pharmacy colleagues in general practices and community
pharmacies are willing to develop mutual relationships, which could result in stronger
links between the two settings and streamlined workloads. Patients are satisfied with
easy access to a pharmacist in general practice who is able to interact with them at a
high standard. Lack of awareness, however, limits uptake of pharmacist-led services.
Conclusions: General practice-based pharmacists could better link different
healthcare teams and enhance accessibility to, and quality of, primary care services.
Ways to effectively capture pharmacist impact are still needed. Findings will inform
policy attempting to frame pharmacist services in general practice as per needs and
expectations of stakeholders