Controversy and consensus on a clinical pharmacist in primary care in the Netherlands.

Aletta W Van Der Wal,Johan J De Gier,Dorien L M Zwart,Anne J Leendertse,Niek J De Wit,Vivianne M Sloeserwij,Ankie C M Hazen,Antoinette A De Bont,Marcel L Bouvy

doi:10.1007/s11096-016-0360-z

Abstract

Background Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation. Objective The aim of this study is to systematically map the debate on this new role for pharmacists amongst all stakeholders to uncover and understand the controversy and consensus. Setting: Primary health care in the Netherlands. Method Q methodology. 163 participants rank-ordered statements on issues concerning the integration of a non-dispensing pharmacist in primary care practice. Main outcome measure: Stakeholder perspectives on the role of the non-dispensing pharmacist and pharmaceutical care in primary care. Results This study identified the consensus on various features of the non-dispensing pharmacist role as well as the financial, organisational and collaborative aspects of integrating a non-dispensing pharmacist in primary care practice. Q factor analysis revealed four perspectives: “the independent community pharmacist”, “the independent clinical pharmacist”, “the dependent clinical pharmacist” and “the medication therapy management specialist”. These four perspectives show controversies to do with the level of professional independency of the non-dispensing pharmacist and the level of innovation of task performance. Conclusion Despite the fact that introducing new professional roles in healthcare can lead to controversy, the results of this Q study show the potential of a non-dispensing pharmacist as a pharmaceutical care provider and the willingness for interprofessional collaboration. The results from the POINT intervention study in the Netherlands will be an important next step in resolving current controversies.

Highlights

Co-locating a non-dispensing pharmacist (NDP) in primary care practice, including shared use of patients’ medical records, is expected to improve interprofessionalInt J Clin Pharm (2016) 38:1250–1260 collaboration and communication and effective patient-centred medication management services [1]
This study identified the consensus on various features of the non-dispensing pharmacist role as well as the financial, organisational and collaborative aspects of integrating a non-dispensing pharmacist in primary care practice
General practitioners and community pharmacists regard the introduction of the non-dispensing pharmacist as a possible route to integrate pharmaceutical care into practice

Summary

Introduction

Co-locating a non-dispensing pharmacist (NDP) in primary care practice, including shared use of patients’ medical records, is expected to improve interprofessional. Int J Clin Pharm (2016) 38:1250–1260 collaboration and communication and effective patient-centred medication management services [1]. Controversy about this new role for pharmacists is hampering implementation. New roles lead to the substitution of labour, including reallocation of resources and control. It has an impact on dominance and authority, fed by the implicit wish to maintain established arrangements for healthcare delivery and by scepticism about the feasibility and effectiveness of related professionals working jointly [6]. Controversy about the introduction of a non-dispensing pharmacist in primary care practice hampers implementation

Methods

Results

Discussion

Conclusion