Coopération entre médecins généralistes et pharmaciens : une revue systématique de la littérature

Michot, Pauline; Catala, O.; Supper, Irène; Boulieu, Roselyne; Zerbib, Yves; Colin, Cyrille; Letrilliart, Laurent

doi:10.3917/spub.253.0331

Cited by 24 publications

(7 citation statements)

References 35 publications

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“…Hitherto, physicians participating in several of these approaches adopted a substantial degree of pharmacists' recommendations for medication change or deprescribing [13,17,18]. Though impact on clinical outcomes is difficult to detect from existing studies [19], collaborative care approaches revealed positive effects for patient-related, procedural and health-economic outcomes [13,[20][21][22][23]. In a wellobserved prospective cohort study in the UK, delegation to clinical pharmacists reduced GP-time spent on key prescribing activities by 51%, equating to 4.9 h of work per week being released [13].…”

Section: Introductionmentioning

confidence: 99%

Professional roles of general practitioners, community pharmacists and specialist providers in collaborative medication deprescribing - a qualitative study

et al. 2020

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Background: Collaborative care approaches between general practitioners (GPs) and pharmacists have received international recognition for medication optimization and deprescribing efforts. Although specialist providers have been shown to influence deprescribing, their profession so far remains omitted from collaborative care approaches for medication optimization. Similarly, while explorative studies on role perception and collaboration between GPs and pharmacists grow, interaction with specialists for medication optimization is neglected. Our qualitative study therefore aims to explore GPs', community pharmacists' and specialist providers' role perceptions of deprescribing, and to identify interpersonal as well as structural factors that may influence collaborative medication optimization approaches. Method: Seven focus-group discussions with GPs, community pharmacists and community specialists were conducted in Hesse and Lower Saxony, Germany. The topic guide focused on views and experiences with deprescribing with special attention to inter-professional collaboration. We conducted conventional content analysis and conceptualized emerging themes using the Theoretical Domains Framework. Results: Twenty-six GPs, four community pharmacists and three community specialists took part in the study. The main themes corresponded to the four domains 'Social/professional role and identity' (1), 'Social influences' (2), 'Reinforcement' (3) and´Environmental context and resources' (4) which were further described by beliefs statements, that is inductively developed key messages. For (1), GPs emerged as central medication managers while pharmacists and specialists were assigned confined or subordinated tasks in deprescribing. Social influences (2) encompassed patients' trust in GPs as a support, while specialists and pharmacists were believed to threaten GPs' role and deprescribing attempts. Reinforcements (3) negatively affected GPs' and pharmacists' effort in medication optimization by social reprimand and lacking reward. Environmental context (4) impeded deprescribing efforts by deficient reimbursement and resources as well as fragmentation of care, while informational and gate-keeping resources remained underutilized.

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Section: Introductionmentioning

confidence: 99%

Professional roles of general practitioners, community pharmacists and specialist providers in collaborative medication deprescribing - a qualitative study

et al. 2020

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“…This is striking since numerous studies from various settings provide evidence for the positive effect of community pharmacists on medication management, patient counselling, health education, and improved care resulting in better clinical outcomes [4–6]. A recent Cochrane Review shows that pharmacist interventions are particularly beneficial for reducing systolic blood pressure, improving HbA1C and blood glucose level, and for the management of asthma [4].…”

Section: Introductionmentioning

confidence: 99%

Perceptions of interprofessional collaboration of general practitioners and community pharmacists - a qualitative study

Löffler

Koudmani

Böhmer

et al. 2017

BMC Health Serv Res

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BackgroundDespite numerous evidences for the positive effect of community pharmacists on health care, interprofessional collaboration of pharmacists and general practitioners is very often limited. Though highly trained, pharmacists remain an underutilised resource in primary health care in most western countries. This qualitative study aims at investigating pharmacists’ and general practitioners’ views on barriers to interprofessional collaboration in the German health care system.MethodsA total of 13 narrative in-depth interviews, and two focus group discussions with 12 pharmacists and general practitioners in Mecklenburg-Western Pomerania, a predominantly rural region of North-Eastern Germany, were conducted. The interviews aimed at exploring general practitioners’ and pharmacists’ attitudes, views and experiences of interprofessional collaboration. At a second stage, two focus group discussions were performed. Fieldwork was carried out by a multi-professional team. All interviews and focus group discussions were audio taped and transcribed verbatim. The constant comparative method of analysis from grounded theory was applied to the data.ResultsThere are three main findings: First, mutual trust and appreciation appear to be important factors influencing the quality of interprofessional collaboration. Second, in light of negative personal experiences, pharmacists call for a predefined, clear and straightforward way to communicate with physicians. Third, given the increasing challenge to treat a rising number of elderly patients with chronic conditions, general practitioners desire competent support of experienced pharmacists.ConclusionsOn the ground of methodological triangulation the findings of this study go beyond previous investigations and are able to provide specific recommendations for future interprofessional collaboration. First, interventions and initiatives should focus on increasing trust, e.g. by implementing multi-professional local quality circles. Second, governments and health authorities in most countries have been and still are reluctant in advancing political initiatives that bring together physicians and pharmacists. Proactive lobbying and empowerment of pharmacists are extremely important in this context. In addition, future physician and pharmaceutical training curricula should focus on comprehensive pharmacist-physician interaction at early stages within both professional educations and careers. Developing and fostering a culture of continued professional exchange and appreciation is one major challenge of future policy and research.

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“…Integration of the eGFR in the prescriptions appeared to them as a supplementary tool for improving this collaboration. A systematic review underlined the fact that the collaboration between general practitioners and pharmacists globally improved the management of the patients, without focalising on patients with CKD (Michot et al ., 2013). In France, a recent decree has recognised these new roles for primary care pharmacists, including extended medical reviews (Arrêté du 9 mars 2018 portant approbation de l’avenant 12 à la convention nationale du 4 mai 2012, organisant les rapports entre les pharmaciens titulaires d’officine et l’assurance maladie, 2018).…”

Section: Discussionmentioning

confidence: 99%

Processes and determinants of integration of eGFR in physicians’ drug prescriptions: a qualitative study of semi-structured interviews

Lefèvre¹,

Jourdain²,

Fournier³

2019

Prim Health Care Res Dev

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Aim:Our objective was to explore the processes and determinants leading physicians to integrate estimated glomerular filtration rate (eGFR) in their drug prescriptionsBackground:Access to patients’ eGFR would allow primary care pharmacists to optimise their role in the procedure of safe prescribing. Some rare physicians actively integrate eGFR in their prescriptions, in a sporadically and uncoordinated manner.Methods:Qualitative study using semi-directed interviews conducted among 12 French physicians who integrated eGFR in their drug prescriptions, (February 2016–April 2017). These voluntary participants were recruited through different means: Twitter®, forums, direct contact and snowball sampling. Data analysis was based on the grounded theory approach, underpinned by a comprehensive perspective of interactionist orientation.Findings:Residency and training, professional experience – including experiences of adverse drug reactions – and the membership in various communities of professionals were key drivers for the integration of eGFR in prescriptions. The theoretical aim was above all safe prescribing in order to reduce adverse drug reactions, with the control by a dispensing pharmacist and/or other healthcare professionals. Nevertheless, none of the physicians had received any feedback from any healthcare professionals. Despite their disappointment, the physicians remained convinced of the interest of integrating eGFR in their prescriptions and would continue to do so. Characteristics associated with integration of eGFR in drug prescriptions belong partly to Roger’s theory of innovations. If a widespread diffusion of this habit takes place, it will be necessary to evaluate its adoption by both physicians and pharmacists.

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Coopération entre médecins généralistes et pharmaciens : une revue systématique de la littérature

Abstract: Cooperation between pharmacists and general practitioners can contribute to improving the quality of primary care, especially in the areas of cardiometabolic and prescription problems.

Cited by 24 publications

References 35 publications

Professional roles of general practitioners, community pharmacists and specialist providers in collaborative medication deprescribing - a qualitative study

Professional roles of general practitioners, community pharmacists and specialist providers in collaborative medication deprescribing - a qualitative study

Perceptions of interprofessional collaboration of general practitioners and community pharmacists - a qualitative study

Processes and determinants of integration of eGFR in physicians’ drug prescriptions: a qualitative study of semi-structured interviews

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