Factors influencing the degree of physician-pharmacist collaboration within Iraqi public healthcare settings

OBJECTIVES

Medication safety and effectiveness can be improved through interprofessional collaboration. The goals of this study were to measure the degree of physician-pharmacist collaboration within Iraqi governmental healthcare settings and to investigate factors influencing this collaboration.

METHODS

This cross-sectional study was conducted in Al-Najaf Province using the Collaborative Working Relationship Model and Physician-Pharmacist Collaborative Instrument (PPCI). Four pharmacists distributed paper surveys with a 7-point Likert scale to a convenience sample of physicians and pharmacists working in seven public hospitals and two outpatient clinics. The questionnaire (in English) covered individual (demographics, practising years and academic affiliation), context (practice setting) and PPCI characteristics (trustworthiness, role specification and relationship initiation) in addition to collaborative care items: one for pharmacists and one for physicians. Separate multiple regressions were used to assess the association of the factors with collaborative care for physicians and for pharmacists.

KEY FINDINGS

Seventy-seven physicians and 86 pharmacists returned usable surveys (81.5% response rate). The majority of physicians were male (84%), while the majority of pharmacists were female (58%). The mean age of the physicians was (37.99 years) older than that of the pharmacists (30.35 years). The physicians had a longer period of practice (11.32 years) than pharmacists (5.45 years). Most (90%) of the providers were practising in hospitals. Pharmacist academic affiliation was significantly associated with collaborative care. The pharmacist and physician regressions indicated significant (P < 0.05) associations between collaborative care and two PPCI domains (role specification and relationship initiation for physicians; role specification and trustworthiness for pharmacists).

CONCLUSIONS

This study focused on physician-pharmacist collaboration within hospitals, and it was the first study measuring interprofessional collaboration in Iraq. The results showed there is physician-pharmacist collaboration within Iraqi hospitals and exchange characteristics had significant influence on this collaboration.

The Patient-Centered Medical Home and Community Pharmacists' Perceptions

Background:

As new models of health care delivery are being discussed, it is important to determine the pharmacist's role within each care model to assist in the provision of clinical services. Recent literature suggests that pharmacists are integral members of the patient-centered medical home (PCMH) and should be included as members of the health care team. As the most accessible health care professionals, community pharmacists are uniquely positioned to play a prominent role within the PCMH, as enhanced access is one of the joint principles of the PCMH care model. To date, no studies have described the barriers to community pharmacists' participation in the PCMH model or their acceptance as members of the PCMH team.

Objective:

To evaluate community pharmacists' perceptions of barriers to participation and acceptance within the PCMH in a community pharmacy chain.

Methods:

Online surveys were made available to 244 community pharmacists working for a supermarket pharmacy chain in Ohio. Pharmacists completed the survey anonymously and indicated their opinions on preparedness to participate in the PCMH, their relationship with other health care providers, their relationship with patients, and their perceived barriers to participation in a PCMH.

Results:

Of the 244 pharmacists contacted, 129 completed the survey (52.9%). In total, 32.6% of responding pharmacists were familiar with the PCMH before the survey. A majority of respondents agreed that pharmacists are sufficiently trained and have the skills required to participate within the PCMH (79.8%, 93.8%, respectively). Only 36.4% of pharmacists agreed that physicians are willing to work closely with community pharmacists. Pharmacists also indicated that they do not have adequate opportunities to meet with other members of their patients' health care team (68.5%).

Conclusions:

Most community pharmacists are still unfamiliar with the concept of the PCMH. Once they were made aware of what a PCMH is, the pharmacists surveyed indicated that they want to be members of a PCMH. Before pharmacists participate in this model of care within the community setting, it is important that they first understand and address the barriers identified from this survey in order to facilitate a smooth transition of pharmacy services into the PCMH.