Maoliosa Donald1, Kathryn King-Shier1, Ross T Tsuyuki1, Yazid N Al Hamarneh1, Charlotte A Jones1, Braden Manns1, Marcello Tonelli1, Wendy Tink1, Nairne Scott-Douglas1, Brenda R Hemmelgarn1. 1. Department of Medicine (Donald, Manns, Tonelli, Scott-Douglass, Hemmelgarn); Interdisciplinary Chronic Disease Collaboration (Donald, Manns, Tonelli, Hemmelgarn); Department of Community Health Sciences (King-Shier, Manns, Tonelli, Hemmelgarn); Faculty of Nursing (King-Shier), University of Calgary, Calgary, Alta.; Department of Medicine (Tsuyuki, Al Hamarneh), EPICORE Centre, University of Alberta, Edmonton, Alta.; Southern Medical Program (Jones), University of British Columbia, Kelowna, BC; Department of Family Medicine (Tink), University of Calgary, Calgary, Alta.
Abstract
BACKGROUND: The RxEACH trial was a randomized trial to evaluate the efficacy of community pharmacy-based case finding and intervention in patients at high risk for cardiovascular (CV) events. Community-dwelling patients with poorly controlled risk factors were identified and their CV risk reduced through patient education, prescribing and follow-up by their pharmacist. Perspectives of patients, family physicians and community pharmacists were obtained regarding pharmacists' identification and management of patients at high risk for CV events, to identify strategies to facilitate implementation of the pharmacist's expanded role in routine patient care. METHODS: We used a qualitative methodology (individual semistructured interviews) with conventional qualitative content analysis to describe perceptions about community pharmacists' care of patients at high risk for CV events. Perceptions were categorized into macro (structure), meso (institution) and micro (practice) health system levels, based on a conceptual framework of care for optimizing scopes of practice. RESULTS: We interviewed 48 participants (14 patients, 13 family physicians and 21 community pharmacists). Patients were supportive of the expanded scope of practice of pharmacists. All participant groups emphasized the importance of communication, ability to share patient information, trust and better understanding of the roles, responsibilities, accountabilities and liabilities of the pharmacist within their expanded role. INTERPRETATION: Despite support from patients and changes to delivery of care in primary care settings, ongoing efforts are needed to understand how to best harmonize family physician and community pharmacist roles across the health system. This will require collaboration and input from professional associations, regulatory bodies, pharmacists, family physicians and patients.
RCT Entities:
BACKGROUND: The RxEACH trial was a randomized trial to evaluate the efficacy of community pharmacy-based case finding and intervention in patients at high risk for cardiovascular (CV) events. Community-dwellingpatients with poorly controlled risk factors were identified and their CV risk reduced through patient education, prescribing and follow-up by their pharmacist. Perspectives of patients, family physicians and community pharmacists were obtained regarding pharmacists' identification and management of patients at high risk for CV events, to identify strategies to facilitate implementation of the pharmacist's expanded role in routine patient care. METHODS: We used a qualitative methodology (individual semistructured interviews) with conventional qualitative content analysis to describe perceptions about community pharmacists' care of patients at high risk for CV events. Perceptions were categorized into macro (structure), meso (institution) and micro (practice) health system levels, based on a conceptual framework of care for optimizing scopes of practice. RESULTS: We interviewed 48 participants (14 patients, 13 family physicians and 21 community pharmacists). Patients were supportive of the expanded scope of practice of pharmacists. All participant groups emphasized the importance of communication, ability to share patient information, trust and better understanding of the roles, responsibilities, accountabilities and liabilities of the pharmacist within their expanded role. INTERPRETATION: Despite support from patients and changes to delivery of care in primary care settings, ongoing efforts are needed to understand how to best harmonize family physician and community pharmacist roles across the health system. This will require collaboration and input from professional associations, regulatory bodies, pharmacists, family physicians and patients.
Authors: Ross T Tsuyuki; Sherilyn K D Houle; Theresa L Charrois; Michael R Kolber; Meagen M Rosenthal; Richard Lewanczuk; Norm R C Campbell; Dale Cooney; Finlay A McAlister Journal: Circulation Date: 2015-06-10 Impact factor: 29.690
Authors: Yazid N Al Harmarneh; Sarah Lamb; Maoliosa Donald; Brenda Hemmelgarn; Kathryn King Shier; Charlotte A Jones; Cliff Mitchell; Ross T Tsuyuki Journal: Can Pharm J (Ott) Date: 2018-05-30
Authors: Michelle D Smekal; Helen Tam-Tham; Juli Finlay; Maoliosa Donald; Chandra Thomas; Robert G Weaver; Robert R Quinn; Kin Tam; Braden J Manns; Marcello Tonelli; Aminu Bello; Navdeep Tangri; Brenda R Hemmelgarn Journal: BMC Nephrol Date: 2019-03-29 Impact factor: 2.388
Authors: Ian Maidment; Emma Young; Maura MacPhee; Andrew Booth; Hadar Zaman; Juanita Breen; Andrea Hilton; Tony Kelly; Geoff Wong Journal: BMJ Open Date: 2021-06-16 Impact factor: 2.692
Authors: Michelle D Smekal; Helen Tam-Tham; Juli Finlay; Maoliosa Donald; Eleanor Benterud; Chandra Thomas; Robert R Quinn; Kin Tam; Braden J Manns; Marcello Tonelli; Aminu Bello; Navdeep Tangri; Brenda R Hemmelgarn Journal: Can J Kidney Health Dis Date: 2018-03-23