Background Pharmacist-led medication review and medication management programs (MMP) are well-known strategies to improve medication safety and effectiveness. If performed interprofessionally, outcomes might even improve. However, little is known about task sharing in interprofessional MMP, in which general practitioners (GPs) and community pharmacists (CPs) collaboratively perform medication reviews and continuously follow-up on patients with designated medical and pharmaceutical tasks, respectively. In 2016, ARMIN (Arzneimittelinitiative Sachsen-Thüringen) an interprofessional MMP was launched in two German federal states, Saxony and Thuringia. The aim of this study was to understand how GPs and CPs share tasks in MMP when reviewing the patients’ medication. Methods This was a cross-sectional postal survey among GPs and CPs who participated in the MMP. Participants were asked who completed which MMP tasks, e.g., checking drug-drug interactions, dosing, and side effects. In total, 15 MMP tasks were surveyed using a 5-point Likert scale ranging from “I complete this task alone” to “GP/CP completes this task alone”. The study was conducted between 11/2020 and 04/2021. Data was analyzed using descriptive statistics. Results In total, 114/165 (69.1%) GPs and 166/243 (68.3%) CPs returned a questionnaire. The majority of GPs and CPs reported (i) checking clinical parameters and medication overuse and underuse to be completed by GPs, (ii) checking storage conditions of drugs and initial compilation of the patient’s medication including brown bag review being mostly performed by CPs, and (iii) checking side-effects, non-adherence, and continuous updating of the medication list were carried out jointly. The responses differed most for problems with self-medication and adding and removing over-the-counter medicines from the medication list. In addition, the responses revealed that some MMP tasks were not sufficiently performed by either GPs or CPs. Conclusions Both GPs’ and CPs’ expertise are needed to perform MMP as comprehensively as possible. Future studies should explore how GPs and CPs can complement each other in MMP most efficiently.
Background Interprofessional medication management in primary care is a recognized strategy for improving medication safety, but it is poorly implemented in Germany. As a pilot project, ARMIN [Arzneimittelinitiative Sachsen-Thüringen] was initiated in 2014 to establish better interprofessional medication management between general practitioners and community pharmacists. Aim The aim of this study was to explore the views of non-participating general practitioners and community pharmacists towards interprofessional medication management within ARMIN and to identify barriers to participation. Method This was an interview study comprising a series of semi-structured telephone interviews. In total, 36 general practitioners and 15 community pharmacists were interviewed in the period between March and June 2020. Data were analyzed using thematic analysis as an inductive approach and the consolidated framework for implementation research as a deductive approach. Results Many general practitioners and community pharmacists had a generally positive attitude towards interprofessional medication management. However, various barriers were identified and categorized into five major themes: (I) collaboration between general practitioners and community pharmacists, e.g. concerning general practitioners’ professional sovereignty and pharmacists’ fear of jeopardizing their relationship with general practitioners when interfering in therapy; (II) eligibility for participation, e.g., the fact that patients had to be insured with a specific statutory health insurance fund; (III) local circumstances, e.g. many pharmacists could not find a collaborating general practitioner (and vice versa). Moreover, patient demand was low, probably because patients were not aware of the program; (IV) information technology, e.g. concerning the lack of available software and data security concerns; and (V) cost–benefit ratio, e.g. the fact that potential benefits were outweighed by program-associated costs. Conclusion The perceived discrepancy between positive attitudes and multiple prevalent barriers indicates considerable potential for further interprofessional collaboration between general practitioners and community pharmacists.
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