General practitioners’ perceptions of the roles of community pharmacists and their willingness to collaborate with pharmacists in primary care

Abstract

Background

Community pharmacists (CPs) have the capacity to contribute to patient care given their expertise in medication and accessibility to residents in the community. However, multidisciplinary patient care programmes where CPs collaborate with general practitioners (GPs) in patient care is rare in Singapore despite increasing healthcare demand.

Objectives

This study explores GPs’ perceptions of CPs’ current roles and GPs’ ideas for and attitudes towards interprofessional collaboration.

Methods

Semi-structured qualitative interviews were conducted with 20 private GPs from August to December 2020 via an online video-chat platform. GPs were recruited from the Primacy Care Research Network (pcRn), primary care networks, and using snowballing strategies. All interviews were recorded, transcribed and coded thematically.

Results

Current working relationships between GPs and CPs appeared amicable but limited. GPs appreciate the existing roles of CPs: dispensing drugs not stocked in their practices and clarifying prescription details. Still, GPs appeared to rarely consider collaborative working. GPs acknowledged that CPs could enhance patient care with initiatives including medication reconciliation and advising on using medical devices. It was suggested that CPs could coordinate the purchase of drugs for primary care networks to improve GPs’ inventory management, but less enthusiasm was expressed for clinical collaborations with CPs. Major concerns about GP–CP clinical collaborations included direct competition with GPs’ own business interests, perceived low acceptability of pharmacy-led services by patients (citing extra time and cost), threat to continuity of care and the absence of a shared patient electronic health record system. Current funding mechanisms do not enable reimbursement of clinical services provided by CPs. Adoption of telemedicine technologies and governmental financial support were identified as possible enablers of GP–CP collaboration.

Conclusions

GPs saw potential in CPs’ increased involvement in patient care, but perceived multiple barriers. Strategies focusing on overcoming these barriers could enable GP–CP collaboration to enhance patient care.

Highlights

1. Multidisciplinary patient care programmes where community pharmacists collaborate with general practitioners remains a challenge in many countries despite increasing healthcare demands.

2. Inter-professionals collaborative care is hindered by direct competition with general practitioners’ own business interests; Perceived low acceptability of pharmacy-led services by patients (inconvenience and extra costs); Threat to continuity of care and absence of a shared patient electronic health record system.

3. Collaborative programmes can be encouraged by adoption of telemedicine technologies and governmental financial support.

Keywords:

• Community pharmacists
• General practitioners
• Interprofessional collaboration
• Patient care
• Primary care

Joy Boon Ka Chong and Clivia Yao Hua Yap are co first authors.

Joy Boon Ka Chong and Clivia Yao Hua Yap are co first authors.

Acknowledgements

The authors gratefully acknowledge and thank Watson’s Personal Cares Stores Pte Ltd management and the Lee Kong Chian School of Medicine Primary Care Research Network for their support. They would also like to thank all the participating GPs for their time and willingness to share their opinions and experiences.

Author contributions

CYHY: conceptualisation, methodology, validation, formal analysis, writing—original and draft. JBKC: conceptualization, methodology, validation, formal analysis, writing—original and draft. SLLT: investigation, validation. XRT: investigation, data curation. YF: validation, formal analysis, data curation, writing—review and editing, project administration. HES: conceptualization, methodology, validation, formal analysis, writing—review and editing, supervision.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Availability of data and materials

The datasets generated during and/or analysed during the current study are not publicly available as consent to release audio transcript was not obtained participants but are available from the corresponding author on reasonable request.

Declarations

Ethics approval and consent to participate

Ethics approval was obtained from the Nanyang Technological University Institutional Review Board (IRB-2019-11-019) before the commencement of the study.

Informed consent

Informed consent was obtained from participants before the interviews were conducted.

Consent for publication

Not applicable. Manuscript does not contain data from any individual person.

Competing interests

The authors have indicated that they have no competing interests with regard to the content of this article.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Notes

1 National Electronic Health Record, the local system of electronic medical records that is shared between participating healthcare institutions.

Additional information

Notes on contributors

Joy Boon Ka Chong

Joy Boon Ka Chong Current affiliation: Principal Clinical Pharmacist, Watson’s Personal Care Stores Pte Ltd, Singapore. Joy is a practising community pharmacist who is interested in primary care research, focusing on innovative patient care services, medication safety and professional development. She hopes that her work will be able to advance the practice of community pharmacy, support pharmacists in their work and to improve patient health outcome.

Clivia Yao Hua Yap

Clivia Yao Hua Yap Current affiliation: Watson’s Personal Care Stores Pte Ltd. As a community pharmacist who also provides pharmaceutical care to nursing home residents, he is interested in how community pharmacists’ patient care role can be expanded, and how pharmaceutical care provided to older adults in primary healthcare can be improved.

Shawn Lien Ler Tan

Shawn Lien Ler Tan Current affiliation: Medical Officer, Ministry of Health Holdings, Singapore. Shawn is interested in primary healthcare research and enjoys working with primary care professionals to understand their views and motivations. Shawn hopes that his work will be able to better inform policymakers to strengthen the primary healthcare system in Singapore.

Xuan Rong Thong

Xuan Rong Thong Current affiliation: Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Xuan Rong is a medical student in Lee Kong Chian School of Medicine. She is interested in improving patient care with research.

Yang Fang

Yang Fang Current affiliation: Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Yang is a health services researcher studying capacity enhancements in primary care and patients’ health seeking experiences. Her research adopts varied methodologies including quantitative, qualitative, and mixed methods. Trained as a psychologist, she is interested in how psychosocial processes shape physical and mental health.

Helen E. Smith

Helen E. Smith Current affiliation: Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore. Helen is a leading exponent of collaborative primary care research and made contributions to primary care internationally. Throughout her career, she has conducted rigorous trials and mixed methods research in primary care to strengthen the evidence base for improving patient outcomes.