Exploring the interprofessional relationships between community pharmacists and general practitioners undertaking a collaborative medicines management service
To improve the outcomes of drug therapy, there is increasing interest in the community pharmacist providing medicines management services (MMS) (Department of Health, 2000b, 2003a). In 2001, the Department of Health funded the Community Pharmacy Medicines Management Project (CPMMP) to evaluate the introduction of a community pharmacy led MMS. This thesis set out to critically assess the views and experiences of community pharmacists and general practitioners (GPs) participating in the CPMMP; exploring how relationships and perceptions of each other could influence community pharmacists carrying out a MMS, from the viewpoint of both community pharmacists and GPs. This is a qualitative study whereby eight focus groups were conducted with thirty five community pharmacists, and semi-structured telephone interviews were carried out with twenty one GPs and twenty eight community pharmacists. Data was analysed using the broad principles of Grounded Theory (Glaser and Strauss, 1967). Almost all pharmacists and GPs stated they had a good working relationship with each other prior to the MMS commencing, although a number of attitudinal barriers were identified. These included professional hierarchy, GPs' lack of awareness of a pharmacist's training and role in health care, and concerns that commercial interests could potentially affect a community pharmacist's advice. However, these data suggested that where there was an established relationship between the two professions, the most positive feedback about the MMS was reported. These data also suggested that some GPs were not supportive for community pharmacists to undertake a MMS and were generally unwillingly for the community pharmacist to have full access to patients' medical records. There were also some concerns around boundary encroachment. The project had a limited impact on improving relationships between community pharmacists and GPs, with relationships and GPs' perceptions remaining unaltered in many instances. This piece of research has highlighted that attitudinal barriers need to be addressed in order to accomplish effective collaborative working between community pharmacists and GPs.