General practitioners’ perceptions of the current status and pharmacists’ contribution to primary care in Iceland

Abstract

Background For the past several years pharmacists' responsibilities have expanded globally from traditional tasks of dispensing medications to collaborating with other health care professionals in patient care. Similar developments have not occurred in outpatient settings in Iceland. Objective The aim of this study was to explore Icelandic general practitioners' views on the current status of primary care, their perceptions of pharmacists as a health care profession, and their attitudes towards future GP-pharmacist collaboration in primary care in Iceland. Setting Twelve primary care clinics in Iceland. Methods Semi-structured in-depth interviews were conducted with general practitioners from different primary care clinics in Iceland. A purposive and snowball sampling technique was used to select participants. All interviews were recorded and transcribed verbatim. The transcripts were categorized by themes and then analyzed using conventional content analysis. Main outcome measure General practitioners' attitudes towards pharmacists. Results Twenty general practitioners from twelve different primary care clinics in Iceland were interviewed. There are several unmet needs regarding medicines and patient monitoring in the Icelandic health care system. General practitioners suggested ways in which these gaps may be addressed and pharmacist-led clinical service was one of the suggestions. Currently, their communication with pharmacists in the primary sector solely surrounds practical non-clinical issues. Due to increasing polypharmacy and multimorbidity, they suggested that pharmacists should be more involved in patient care. Conclusions General practitioners believe that pharmacist-led clinical service can increase the quality of patient therapy. To improve communication between these health care providers, pharmacists must also re-professionalize (strengthening the profession´s status through new responsibilities and tasks), not having a conflict of interest and showing that they have expertise in patient care.

Factors influencing national implementation of innovations within community pharmacy: a systematic review applying the Consolidated Framework for Implementation Research

“…Roberts et al also identified that communication with doctors and their attitudes influenced successful implementation of cognitive pharmacy services [20], whilst Shoemaker et al identified cosmopolitanism and engagement of the wider healthcare setting to be a facilitator [21]. General practitioners have previously reported lack of collaboration with community pharmacies [104], with evidence that they are cautious about their adoption of new services [105] and clinical roles [106–109].…”

Introducing Pharmaceutical Care to Primary Care in Iceland—An Action Research Study

“…These groups cannot demand services that they do not recognize as necessary. The main challenge regarding pharmacist-GP collaboration in Iceland is that GPs neither know pharmacists as health care providers nor their clinical services [ 20 ]. This study was the first in introducing pharmacists as potential patient care providers in an established primary care clinic in Iceland.…”

“…In Iceland, pharmaceutical care services are provided in hospitals but not in other settings of care, despite the requirement for pharmaceutical care provision being written into legislation in 1994 [ 19 ]. The main challenge in Iceland is that, currently, there is little communication between community pharmacists and general practitioners (GPs) on clinical issues [ 20 ], even though globally pharmacists are taking on a larger role as primary care patient care providers [ 1 ]. GPs do not recognize pharmacists as health care providers, nor do they have any experience with pharmacist-led clinical services [ 20 ].…”

“…The main challenge in Iceland is that, currently, there is little communication between community pharmacists and general practitioners (GPs) on clinical issues [ 20 ], even though globally pharmacists are taking on a larger role as primary care patient care providers [ 1 ]. GPs do not recognize pharmacists as health care providers, nor do they have any experience with pharmacist-led clinical services [ 20 ]. International studies abound on the impact of clinical pharmacy services on patient outcomes [ 21 ] and some interventions have focused on pharmacist–GP cooperation [ 22 ].…”

General Practitioners' Propensity to Cooperate With Other Health Professionals in the Management of Patients With Multimorbidity and Polypharmacy: A Cross-sectional Study.

“…Their involvement in patient counselling, therapeutic education or the training of other health professionals would have a positive impact on the patients follow-up, their treatment adherence and their quality of life [22]. In the same time, the frequent limitation of cooperation between GPs and pharmacists to clari cation of prescriptions, drug-related information, or information about patient history reduces its potential bene ts [24][25][26]. Moreover, contacts are occasional and mostly at the pharmacists' initiative.…”