Inter-professional collaboration between general practitioners and community pharmacists: general practitioners’ perspectives

Abstract

The global movement towards enhancing inter-professional collaboration in patient care is in light of the increasing potency of drugs and complexity of drug regimens, particularly in the chronically ill where poly-pharmacy is rife, collaborative patient management by general practitioners and community pharmacists, in particular, has the potential to enhance patient therapeutic outcomes in primary healthcare. Literature from other parts of the world has enumerated the advantages of collaboration. South Africa with its unusual quadruple burden of disease and human resource deficient public healthcare system would benefit from collaboration between general practitioners and community pharmacists through expanded roles for community pharmacists to enable them to make more meaningful contributions to primary healthcare regimens. Particularly with the introduction of the National Health Insurance (NHI) programme. This dissertation aims to assess from general practitioners‟ perspectives: the current level and stage of collaboration (using the collaborative working relationship (CWR) model proposed by McDonough and Doucette, 2001) between general practitioners and community pharmacists in patient care, if general practitioners‟ perceptions of the professional roles of community pharmacists in patients‟ care can influence desired collaboration (prospects of enhanced future collaboration) and how do general practitioners envision enhanced future collaboration between them and community pharmacists in patient care, possible barriers to the envisioned collaboration between the two practitioners, and how general practitioners‟ demographic characteristics influence inter-professional collaboration with community pharmacists. Sixty randomly selected consenting general practitioners in private practice participated in a cross-sectional, face- to-face questionnaire study. The questionnaire contained a range of statements with Likert scale response options. Data was initially entered into Epi Info (version 3.5.1., 2008) and then exported to IBM SPSS Statistical software for analysis (version19, 2010). Medians were used to summarize descriptive data and Spearman‟s correlation coefficient, Mann-Whitney U Test and Kruskal-Wallis Test was used for bivariate analysis. Ethical approval was granted by the Senate Research and International Relations Committee, University of the Western Cape (Ethical Clearance Number: 10/4/29). The results indicated low-levels of current collaboration at stage 0 of the CWR model between general practitioners and community pharmacists. A statistically significant correlation was observed between general practitioners‟ perceptions of the professional roles of community pharmacists and desired collaboration (prospects of enhanced future collaboration), [p=0.0005]. Good prospects of enhanced future collaboration between general practitioners and community pharmacists were observed. General practitioners identified barriers to collaboration to include: the lack of remuneration for collaboration, absence of a government mandate or policy supporting collaboration, inability of general practitioners to share patients‟ information with community pharmacists and questionable professional ethics exhibited by community pharmacists particularly over financial gains. Most general practitioners agreed that joint continuing professional education organized by pharmaceutical companies or other groups will increase interaction and enhance collaboration. Enhanced Inter-professional collaboration between general practitioners and community pharmacists‟ can be possible in the future but hindrances need to be eliminated for this to be achieved. Future research can be aimed at exploring the perspectives‟ of community pharmacists to inter-professional collaboration in South Africa and interventions that will enhance collaboration.