General practitioners’ perceptions on home medicines reviews: a qualitative analysis

Abstract

BackgroundHome Medicines Review (HMR) is an Australian initiative introduced in 2001 to improve quality use of medicines. Medication management services such as HMRs have the potential to reduce medication related problems. In 2011, changes to the HMR program were introduced to allow for referrals directly to accredited pharmacists in addition to the community pharmacy referral model. These changes were introduced to improve efficiency of the process. This study explored the perceptions of Western Australian general practitioners (GPs) on benefits and barriers of the HMR service and process, including their insights into the direct referral model.MethodsPurposive sampling of GPs who had experience ensured that participants had a working knowledge of the HMR service. Semi structured interviews with 24 GPs from 14 metropolitan Western Australian medical centres between March and May 2013. Transcribing and thematic analysis of data were performed.ResultsMost GPs had positive attitudes towards the HMR service. Main perceived benefits of the service were poly-pharmacy reduction and education for both the GP and patient. Strategies identified to improve the service were introduction of a standard HMR report template for pharmacists and better use of technology. Whilst reliability and GPs’ familiarity were the main perceived benefits of the direct referral model, a number of GPs agreed that patient unfamiliarity with the HMR pharmacist was a barrier.ConclusionsDespite recognition of the value of the HMR service participating GPs were of the opinion that there are aspects of the HMR service that could be improved. As one of the success factors of HMRs is relying on GPs to utilise this service, this study provides valuable insight into issues that need to be addressed to improve HMR uptake.

Improving medication safety for home nursing clients: A prospective observational study of a novel clinical pharmacy service-The Visiting Pharmacist (ViP) study

“…There is a low HMR participation rate from GPs and a poor awareness among patients. 14,[17][18][19][20][21] Low GP participation has been reported to relate to the cumbersome consent, referral and implementation processes, and inconsistent quality of service provided by pharmacists. 18,19 Attempts to increase HMR uptake, including for home nursing clients, have been unsuccessful.…”

Solidarity or dissonance? A systematic review of pharmacist and GP views on community pharmacy services in the UK

“…Furthermore, there have been concerns over the retail context of community pharmacies introducing structural and organisational barriers to integration between community pharmacies and GP practices (Jacobs et al., ; Royal Pharmaceutical Society, ). Consequently, pharmacists have been sceptical towards role expansion (Anderson, Blenkinsopp, & Armstrong, ; Eades et al., ; Hall, Donovan, & Wilkes, ) and GPs have been reluctant to accept extended services despite their potential to reduce their pressure and workload (Dhillon, Hattingh, Stafford, & Hoti, ; Hossain et al., ; McGrath et al., ; Smith, Cannon‐Breland, & Spiggle, ).…”

Home healthcare professionals’ perspectives on quality dimensions for home pharmaceutical care in Japan

“…Not surprisingly, approximately one‐half of the QD identified in the present study overlapped with barriers and facilitators to home pharmacy service provision identified in different countries, specifically, Australia, Canada, UK and USA . However, some QD specifically related to HPC (i.e.…”

“…Not surprisingly, approximately one-half of the QD identified in the present study overlapped with barriers and facilitators to home pharmacy service provision identified in different countries, specifically, Australia, Canada, UK and USA. [21][22][23][24] However, some QD specifically related to HPC (i.e. working policy, collaborative visiting schedule arrangement, non-professional services, timeliness of sharing information, grief care, withdrawal of the service).…”