Competencies required for General Practice Clinical Pharmacists providing the Scottish Pharmacotherapy Service: A modified eDelphi study

Abstract

Due to work load pressures in primary care, increasing efforts are being made internationally to implement pharmacists working alongside general practitioners. While there is wide interest in the contributions pharmacists can make within primary care, there is limited research which explores the competencies pharmacists need to safely and effectively provide care in this arena. Therefore, a modified eDelphi study was conducted between July 2019 and January 2020 among pharmacists working in General Practice in Scotland in order to (a) generate a list of competencies required to undertake pharmacotherapy tasks within General Practice using content analysis; and (b) establish consensus regarding the importance of these competencies using a rating scale ranging from 1 ("not important") to 10 ("very important"). A framework of competencies was developed, containing eight competency categories with a total of 31 individual competency items. Overall, study participants considered all eight competency categories as being important, with a mode of 10 and a median >8; agreement among participants was high, with the majority of individual competency items rated 8 or above by more than 75% of participants. There was, however, variation in responses with regards to specific tasks such as medicines reconciliation and medication compliance reviews. Findings indicate that the GP setting requires a broad set of competencies-covering areas including the use of IT systems; clinical knowledge; and communicating with patients and other healthcare professionals. This implies that further emphasis on clinical and consultation skills should be added to training programmes aimed at GP pharmacists; furthermore, ongoing support is also needed with regards to generic skills such as the use of IT systems, documentation, and general procedures and processes within primary care, some of which might need to be tailored to the specific practice context.

Pharmacists in Australian general practice: Discussion of the findings of an evaluation from 2016 to 2021

“…Pharmacy services in general practice are more defined and widespread in Scotland, where most practices had some access to the government‐funded Pharmacotherapy Service by June 2022 11 . In Scotland, general practice clinical pharmacists deliver advanced and specialist services (comprehensive medication reviews, high‐risk medication monitoring, specialist clinics), while core tasks (including prescription management, medication recalls, compliance reviews) are mainly delivered by pharmacy technicians and support workers 12,13 …”

“…11 In Scotland, general practice clinical pharmacists deliver advanced and specialist services (comprehensive medication reviews, high-risk medication monitoring, specialist clinics), while core tasks (including prescription management, medication recalls, compliance reviews) are mainly delivered by pharmacy technicians and support workers. 12,13 General practice pharmacists in Australia are acceptable to relevant stakeholders, 14,15 recommended by the Consumers Health Forum of Australia, 16 and have demonstrated benefits to patients. [17][18][19] However, a relative lack of consistent clinical outcome data, some resistance within the pharmacy profession, and a lack of sustainable funding are among the key issues that have hindered widespread implementation.…”