Collaborative discussions between GPs and pharmacists to optimise patient medication: a qualitative study within a UK primary care clinical trial.

IF 5.3 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
British Journal of General Practice Pub Date : 2024-10-31 Print Date: 2024-11-01 DOI:10.3399/BJGP.2024.0190
Roxanne M Parslow, Lorna J Duncan, Barbara Caddick, Carolyn A Chew-Graham, Katrina Turner, Rupert A Payne, Cindy Man, Bruce Guthrie, Peter S Blair, Deborah McCahon
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Abstract

Background: There has been significant investment in pharmacists working in UK general practice to improve the effective and safe use of medicines. However, evidence of how to optimise collaboration between GPs and pharmacists in the context of polypharmacy (multiple medication) is lacking.

Aim: To explore GP and pharmacist views and experiences of in-person, interprofessional collaborative discussions (IPCDs) as part of a complex intervention to optimise medication use for patients with polypharmacy in general practice.

Design and setting: A mixed-method process evaluation embedded within the Improving Medicines use in People with Polypharmacy in Primary Care (IMPPP) trial conducted in Bristol and the West Midlands, between February 2021 and September 2023.

Method: Audio-recordings of IPCDs between GPs and pharmacists, along with individual semi-structured interviews to explore their reflections on these discussions, were used. All recordings were transcribed verbatim and analysed thematically.

Results: A total of 14 practices took part in the process evaluation from February 2022 to September 2023; 17 IPCD meetings were audio-recorded, discussing 30 patients (range 1-6 patients per meeting). In all, six GPs and 13 pharmacists were interviewed. The IPCD was highly valued by GPs and pharmacists who described benefits, including: strengthening their working relationship; gaining in confidence to manage more complex patients; and learning from each other. It was often challenging, however, to find time for the IPCDs.

Conclusion: The model of IPCD used in this study provided protected time for GPs and pharmacists to work together to deliver whole-patient care, with both professions finding this beneficial. Protected time for interprofessional liaison and collaboration, and structured interventions may facilitate improved patient care.

药剂师与全科医生合作讨论,优化患者用药:临床试验中的定性研究。
背景:为提高药物使用的有效性和安全性,英国对在全科诊所工作的药剂师进行了大量投资。目的:探讨全科医生和药剂师对亲身参与的跨专业合作讨论(IPCDs)的看法和体验,该讨论是一项复杂干预措施的一部分,旨在优化全科多药患者的用药:在布里斯托尔和西米德兰兹开展的 "改善基层医疗机构多药合用患者的用药"(IMPPP)试验中进行的混合方法过程评估:方法:对全科医生和药剂师之间的 IPCD 进行录音,并进行个人半结构式访谈,探讨他们对这些讨论的反思。所有录音均被逐字转录并进行专题分析:14 家诊所参与了过程评估(2021 年 2 月至 2023 年 9 月)。对 17 次 IPCD 会议进行了录音,讨论了 30 名患者(每次会议讨论 1-6 名患者)。对 6 名全科医生和 13 名药剂师进行了访谈。IPCD 得到了全科医生和药剂师的高度评价,他们认为 IPCD 的益处包括:加强了他们的工作关系;相互学习;增强了管理更复杂病人的信心。然而,要抽出时间开展 IPCD 常常具有挑战性:结论:所研究的 IPCD 模式为全科医生和药剂师提供了受保护的工作时间,使他们能够共同为患者提供全程护理,双方都认为这样做是有益的。为跨专业联络与合作以及结构化干预提供保护时间可能有助于改善患者护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
British Journal of General Practice
British Journal of General Practice 医学-医学:内科
CiteScore
5.10
自引率
10.20%
发文量
681
期刊介绍: The British Journal of General Practice is an international journal publishing research, editorials, debate and analysis, and clinical guidance for family practitioners and primary care researchers worldwide. BJGP began in 1953 as the ‘College of General Practitioners’ Research Newsletter’, with the ‘Journal of the College of General Practitioners’ first appearing in 1960. Following the change in status of the College, the ‘Journal of the Royal College of General Practitioners’ was launched in 1967. Three editors later, in 1990, the title was changed to the ‘British Journal of General Practice’. The journal is commonly referred to as the ''BJGP'', and is an editorially-independent publication of the Royal College of General Practitioners.
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