Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety

ABSTRACT

Introduction

Over 4 billion prescriptions are dispensed each year to patients in the United States, with the number of prescriptions continuing to increase. There is a growing recognition of pharmacists’ potential in improving medication safety in community settings, in collaboration with primary care providers (PCPs). However, the nature of collaboration has not been well defined, and barriers and strategies are not articulated.

Area covered

For this narrative review, published studies were retrieved from PubMed between January 2000 and December 2020. Search terms included “patient safety,” “medication safety,” ”collaboration,” “primary care physician,” and “community pharmacy.” Resulting articles were categorized as follows: defining collaboration, types of collaboration, and barriers and solutions to collaboration.

Expert opinion

It is important to understand the factors within a community pharmacy setting that limit or facilitate community pharmacists’ participation in medication safety activities. Strategies such as medication review are a common form of collaboration. Barriers to collaboration include misconceptions regarding roles and differences in access to clinical information and community pharmacy practice variability. Future recommendations include increasing training and utilization of pharmacists/PCP teams, increasing community pharmacists’ practice in emerging roles, and expanding the community pharmacist role in transitions of care from the hospital to the community.

KEYWORDS:

• Medication safety
• older adults
• community pharmacists
• primary care physicians
• collaboration

Article highlights

• Collaboration can involve synchronous and asynchronous efforts in working on specific patient care tasks and in establishing relationships between PCPs and community pharmacists, such as trust, interdependence, and perceptions and expectations of each party toward the other.

• This study highlights key examples of collaborative activities between PCPrs and pharmacists, including medication review, drug safety management, and patient education.

• Top barriers to collaboration include lack of role specification, lack of direct face-to-face communication, tendency to avoid direct interactions, and lack of communication standards.

• More research is needed into how to optimize PCP–community pharmacist collaboration to improve medication safety.

This box summarizes key points contained in the article.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contribution

A White contributed to: Project Administration, Supervision, Conceptualization, Data Curation, Formal Analysis, Methodology, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review and Editing; K Fulda contributed to: Writing – Conceptualization, Data Curation, Formal Analysis, Methodology, Validation, Visualization, Writing – Original Draft Preparation, Review and Editing; R Blythe contributed to: Data Curation, Formal Analysis, Methodology, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review and Editing; M Chui contributed to: Writing – Conceptualization, Data Curation, Methodology, Validation, Writing – Original Draft Preparation, Writing – Review and Editing; E Reeve contributed to: Conceptualization, Methodology, Validation, Visualization, Writing – Original Draft Preparation, Writing – Review and Editing; R Young contributed to: Conceptualization, Data Curation, Methodology, Validation, Writing – Original Draft Preparation, Writing – Review and Editing; A Espinoza contributed to: Conceptualization, Methodology, Validation, Writing – Original Draft Preparation, Writing – Review and Editing; N Hendrix contributed to: Writing – Conceptualization, Review and Editing; Y Xiao contributed to: Funding Acquisition, Project Administration, Supervision, Resources, Conceptualization, Data Curation, Formal Analysis, Methodology, Validation, Visualization Writing – Original Draft Preparation, Writing – Review and Editing.

Additional information

Funding

This paper was supported by the Agency for HealthCare Research and Quality under Grant [R18HS027277] and by an Australian National Health and Medical Research Council (NHMRC) Investigator Grant [GNT1195460 to ER]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the sponsors.