Evaluation of a Danish pharmacist student-physician medication review collaboration model.

Abstract

Interprofessional collaboration between pharmacists and physicians to conduct joint home medication reviews (HMR) is important for optimizing the medical treatment of patients suffering from chronic illnesses. However, collaboration has proved difficult to achieve. The HMR programme "Medisam" was launched in 2009 at the University of Copenhagen with the aim of "developing, implementing and evaluating a collaboration model for HMRs and medicine reconciliations in Denmark". The Medisam programme involves patients, pharmacy internship students, the (pharmacist) supervisor of the pharmacy students and physicians. To explore if it was possible through the Medisam programme to obtain a fruitful HMR collaboration between pharmacy internship students and physicians as a means to develop HMR collaboration between trained pharmacists and physicians further. Ten matching pairs of student-physician collaboration were studied across Denmark. Semi-structured interviews about existing collaboration were conducted with pharmacy internship students in the HMR programme, their supervisors and physicians partners. The theoretical framework forming the analyses was derived especially from works of Bradley et al. (Res Soc Adm Pharm 8:36-46, 2012), and Snyder et al. (Res Soc Adm Pharm 6:307-23, 2010) on pharmacists/physician collaboration. The development of inter-professional collaboration between students and physicians according to the three collaboration drivers: trustworthiness, role specification and professional interaction. Full collaboration was not achieved. Physicians found collaboration satisfactory, students however expressed the need of more interaction with physicians. The written collaboration contracts did not ensure a possible need of students to re-negotiate roles and tasks, and did therefore not entirely ensure role specification. Developing mutual professional interdependence through students being recognized by physicians to contribute to improved patient outcomes was also limited. Some challenges to fruitful collaboration were identified. Solutions to these challenges include students and their pharmacist supervisors to find ways to present their collaborative needs to physicians and for students to illustrate more explicitly the benefits patient achieve if physicians implement the recommendations of students.