Evaluation of multisectoral interprofessional collaboration for non-communicable disease management within a municipal setting: a mixed methods study.

Abstract

Background: Strengthening multisectoral collaboration is essential for NCD prevention and control. In Ghana, the healthcare system often experiences inefficiencies due to fragmented care pathways and limited patient engagement. In this study, we assessed the collaboration and level of satisfaction on collaboration between healthcare professionals (HCPs) in hospital settings and Community pharmacists (CPs) in community pharmacies in the management of Diabetic/hypertensive (DM/HPT) patients in Ghana.

Method: This was a cross-sectional study conducted in the Oforikrom municipality in Kumasi Metropolis. A mixed methods approach was used. Participants included all CPs and HCPs practicing in the municipality, as well as DM/HPT patients receiving care at the study site. Quantitative data was collected through online questionnaires. To gather qualitative insights, semi-structured interviews were further conducted. The interviews were audio-recorded and transcribed, and key themes were extracted.

Results: A total of 170 participants (HCPs (n = 30), CPs (n = 39), and DM/HPT patients (n = 101)) completed the survey. Subsequently, seven (7) CPs and five (5) HCPs also participated in interviews. The study showed that CPs, HCPs and DM/HPT patients collaborated through practices such as sending referrals & making recommendations for therapy, follow-ups on patients' therapy and outcomes assessment, providing feedback, adherence support and reminders. The quantitative data suggested a potential communication gap in the referral process between CPs and HCPs. The qualitative data showed that, despite both CPs and HCPs acknowledging the benefits of collaborative practice, it is currently limited. Furthermore, the study revealed varied levels of satisfaction on collaboration for NCD management. An equal proportion (40%) of both CPs and HCPs expressed satisfaction with their collaborative practices with each other, and 25% from each group reported dissatisfaction. The remaining participants were neither satisfied nor dissatisfied. The majority (78%) of CPs and an appreciable proportion of patients (34%) were satisfied with their collaborative relationship for patient care. However, a significant proportion (60%) of patients were dissatisfied with the overall collaboration between HCPs and CPs.

Conclusion: The study highlights gaps in collaborative practice between healthcare providers (CPs, HCPs) and NCD patients, notably revealing patient dissatisfaction with the overall inter-professional collaboration, indicating a need for improved communication, bi-directional referral systems, and teamwork to optimize care and improve health outcomes.