Shifts in expectations: Evaluating physicians' perceptions as pharmacists become integrated into family practice

Abstract

The objective of this study was to measure how primary care family physicians perceived their own and pharmacists' contributions to medication processes as pharmacists become integrated into primary care group family practices. The 22- item Family Medicine Medication Use Processes Matrix was mailed to physicians in seven sites at the 3rd, 12th and 19th month of pharmacist integration. Paired sample t-tests for the third month results were conducted to compare perceptions between pharmacist and physician contributions. One way repeated measure ANOVA test was conducted to determine significant changes over time. Physicians initially perceived their own contributions to be significantly higher than pharmacists in three subscales: Diagnosis & Prescribing, Monitoring and Administration/Documentation and their own contributions to be significantly lower than the pharmacists in the Education subscale. Over time, physicians perceived increases in the pharmacists' contribution to the Diagnosis & Prescribing, Monitoring and Medication Review subscales and decreases in their own contribution to the Diagnosis & Prescribing and Education subscales. Changes in family physicians' perceptions of pharmacists' contribution demonstrate an initial underestimate of pharmacists' role in primary care family practice and a gradual recognition of expertise and competence. This may have led to increased comfort in sharing aspects of contribution to medication use processes.

Keywords:

• Pharmacist
• family physician
• medication use process
• perception
• primary care

Acknowledgements

We would like to acknowledge the contributions of Susan Haydt and Carmel Martin to helping in the design of the MUPM instrument and for their helpful comments on an early draft of this article.

This paper is published on behalf of the IMPACT team members: Integrating family Medicine and Pharmacy to Advance primary Care Therapeutics. IMPACT was a large-scale demonstration project funded by the Ontario Ministry of Health and Long-Term Care (MOHLTC) through the Primary Health Care Transition Fund. The views expressed in the report/paper are the views of the authors and do not necessarily reflect those of the Ministry of Health and Long-Term Care.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Note

To view a copy of the final MUPM questionnaire, go to www.impacteam.info and click on “Resources for Pharmacists in Primary Care Practice”. Then click on “Resources”, complete disclaimer form (found under “Disclaimer Form”) to obtain a password. Click on “IMPACT Resource Downloads”, enter the password provided, and then click on “Family Practice Medication Use Processes Matrix” found at the bottom of the page.