Resident physicians’ perceptions of ambulatory care pharmacy

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Keywords

Pharmacists, Physicians, Interprofessional Relations, Attitude of Health Personnel, Patient Care Team, Professional Role, Ambulatory Care, Surveys and Questionnaires, Indiana

Abstract

Background: Physicians' acceptance of clinical pharmacy services is dependent on exposure to those services, with use increasing as resident physicians progress through their training. Resident physicians train within environments that have a multidisciplinary teaching and clinical care approach, working closely with other healthcare professionals. Ambulatory care pharmacists are increasingly working with resident physicians in clinic settings as part of the multidisciplinary team, and identification of resident physicians’ perceptions may influence future collaboration.


Objective: The objective of this research is to evaluate the perception of ambulatory care clinical pharmacy services from the perspective of resident physicians.


Methods:  A statewide network of ambulatory care pharmacists was identified and received an electronic questionnaire. Pharmacists working within clinics that serve as training sites for resident physicians then completed and distributed questionnaires to the resident physicians within their clinical site. Items related to demographics and perception of involvement and interactions with clinical pharmacists.


Results: Forty-five resident physicians responded from four unique clinical sites (response rate = 42%).  They agreed or strongly agreed that pharmacists help patients obtain their therapeutic goals (97.8%), are able to educate patients effectively (95.6%), provide high quality care (97.8%), and do a good job helping co-manage patients (91.1%). Previous exposure to pharmacists was limited primarily to the drugstore (48.9%) and hospital (51.1%) settings. Resident physicians in the third year of training and those reporting a friend was a pharmacist, were more likely to have a positive perception of the pharmacist’s role as a resident educator (p=0.048 and p=0.044, respectively).


Conclusions: Resident physicians with a longer duration of exposure and personal friendship with a pharmacist are more likely to express positive perceptions. Areas for further enhancements in this interprofessional relationship related to perceptions about pharmacist autonomy and patient relationships were identified.

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References

1. Helling DK, Johnson SG. Defining and advancing ambulatory care pharmacy practice: it is time to lengthen our stride. Am J Health Syst Pharm. 2014;71(16):1348-1356. https://doi.org/10.2146/ajhp140076
2. Hammond RW, Schwartz AH, Campbell MJ, Remington TL, Chuck S, Blair MM, Vassey AM, Rospond RM, Herner SJ, Webb CE; American College of Clinical Pharmacy.Collaborative drug therapy management by pharmacists-2003. Pharmacotherapy. 2003;23(9):1210-1225.
3. American College of Clinical Pharmacy, McBane SE, Dopp AL, Abe A, Benavides S, Chester EA, Dixon DL, Dunn M, Johnson MD, Nigro SJ, Rothrock-Christian T, Schwartz AH, Thrasher K, Walker S. Collaborative drug therapy management and comprehensive medication management – 2015. Pharmacotherapy. 2015;35(4):e39-e50. https://doi.org/10.1002/phar.1563
4. Smith WE, Ray MD, Shannon DM. Physicians’ expectations of pharmacists. Am J Health Syst Pharm. 2002;59(1):50-57. https://doi.org/10.1093/ajhp/59.1.50
5. Helling DK, Thies PW, Rakel RE. The effect of clinical pharmacy services on family practice residents’ attitudes: a nationwide study. Drug Intell Clin Pharm. 1986;20(6):493-496.
6. Voris JC, Anderson RJ, Kimberlin CL. Physician and pharmacy student expectations of pharmacy practice. Am J Pharm Educ. 1982;46(1):37-41.
7. McDonough RP, Doucette WR. A conceptual framework for collaborative working relationships between pharmacists and physicians. J Am Pharm Assoc. 2001;41:682-692.
8. Carter BL. Primary care physician-pharmacist collaborative care model: Strategies for implementation. Pharmacotherapy. 2016;36(4):363-373. https://doi.org/10.1002/phar.1732
9. Dickerson LM, Denham AM, Lynch T. The state of clinical pharmacy practice in family practice residency programs. Fam Med. 2002;34(9):653-657.
10. Jarret JB, Lounsbery JL, D’Amico F, Dickerson LM, Franko J, Nagle J, Seehusen DA, Wilson SA. Clinical pharmacists as educators in family medicine residency programs: a CERA study of program directors. Fam Med. 2016;48(3):180-186.
11. Ables AZ, Baughman OL III. The clinical pharmacist as a preceptor in a family practice residency training program. Fam Med. 2002;34(9):658-662.
12. Jorgenson D, Muller A, Whelan AM. Pharmacist educators in family medicine residency programs: a qualitative analysis. BMC Med Educ. 2012;12:74. https://doi.org/10.1186/1472-6920-12-74
13. Love DW, Hodge NA, Foley WA. The clinical pharmacist in a family practice residency program. J Fam Pract. 1980;10(1):67-72.
14. Mercer K, Neiterman E, Guirguis L, Burns C, Grindrod K. “My pharmacist”: Creating and maintaining relationship between physicians and pharmacists in primary care settings. Res Social Adm Pharm. 2019 [ahead of print]. https://doi.org/10.1016/j.sapharm.2019.03.144
15. Lounsbery JL, Moon J, Humphrey A, Prasad S. Optimizing resident physician use of clinical pharmacy services. Fam Med. 2013;45(1):33-36.
16. Sullivan GM, Artino AR Jr. Analyzing and interpreting data from Likert-type scales. J Grad Med Educ. 2013;5(4):541-542. https://doi.org/10.4300/JGME-5-4-18
17. Gordon C, Unni E, Montuoro J, Ogborn DB. Community pharmacist-led clinical services: physician’s understanding, perceptions, and readiness to collaborate in a Midwestern state in the United States. Int J Pharm Pract. 2018;26(5):407-413. https://doi.org/10.1111/ijpp.12421
18. Al-Jumaili AA, Al-Rekabi MD, Doucette WR, Hussein AH, Abbas HK, Hussein FH. Factors influencing the degree of physician-pharmacist collaboration within Iraqi public healthcare settings. Int J Pharm Pract. 2017;25(6):411-417. https://doi.org/10.1111/ijpp.12339
19. Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50(10):1129-1136. https://doi.org/10.1016/S0895-4356(97)00126-1
20. Cho YI, Johnson TP, VanGeest JB. Enhancing surveys of health care professionals: a meta-analysis of techniques to improve response. Eval Health Prof. 2013;36(3):382-407. https://doi.org/10.1177/0163278713496425
21. Cook JV, Dickinson HO, Eccles MP. Response rates in postal surveys of healthcare professionals between 1996-2005: an observational study. BMC Health Serv Res. 2009;9:160. https://doi.org/10.1186/1472-6963-9-160
22. Cummings SM, Savitz LA, Konrad TR. Reported response rates to mailed physician questionnaires. Health Serv Res. 2001;35(6):1347-1355.
23. McLeod CC, Klabunde CN, Willis GB, Stark D. Health care provider surveys in the United States, 2000-2010: a review. Eval Health Prof. 2013;36(1):106-126. https://doi.org/10.1177/0163278712474001