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.
Highlights
Pressure within General Practice has been increasing globally in recent years (Avery, 2017; Bradley et al, 2018)
There has been a shift in workload from secondary care to primary care, which may increase pressure by causing additional workload for general practitioners (GPs)
Research from Australia found a positive reception to this move, with GPs believing that pharmacists facilitate effective pharmacotherapy, despite earlier research highlighting a possible lack of GP support (Benson et al, 2019; Tan et al, 2014)
Summary
Pressure within General Practice has been increasing globally in recent years (Avery, 2017; Bradley et al, 2018). High levels of dissatisfaction among GPs— not least due to increasing workload—have had a negative impact on both recruitment and retention, with many GPs choosing to leave practice (Owen et al, 2019). To help alleviate the pressure in primary care, efforts have been made to introduce pharmacists into General Practice, working together with GPs and other practice staff—for instance, in Australia and the Netherlands (Hazen, de Groot, de Bont, et al, 2018; Polasek et al, 2015). Research from Australia found a positive reception to this move, with GPs believing that pharmacists facilitate effective pharmacotherapy, despite earlier research highlighting a possible lack of GP support (Benson et al, 2019; Tan et al, 2014)
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