Physician Readiness to Collaborate with Community Pharmacists on Drug Therapy Management

Abstract

Background:

With the increasing importance of drugs in patients' therapy and their rising costs, health policy makers are focusing attention on strategies to enhance the safety and effectiveness of drug prescribing and use. Close pharmacist-physician collaboration has been shown to increase the safety and cost-effectiveness of drug therapy; however, it occurs relatively infrequently in the community setting, with respect to drug therapy management. The majority of the research to date has focused on the pharmacists' views of the collaborative relationship.

Purpose:

The goals of this research were to ascertain Ontario family physician readiness to collaborate with community pharmacists on drug therapy management, to examine whether physician readiness varies across urban and rural settings, and to ascertain potential predictors (sociodemographic and attitudinal) of physician readiness to collaborate.

Methods:

A 22-item survey instrument, developed based on the Transtheoretical Model of Behaviour Change, was distributed by fax and mail to a stratified random sample of 848 family physicians and general practitioners across Ontario. The stratification was based on physicians' practice location in urban or rural area.

Results:

The survey response rate was 36%. Physicians communicated with pharmacists mostly concerning dispensing-related issues and rarely used pharmacists as their primary source of medication information. Eighty-four percent of respondents regularly took community pharmacists' phone calls, while 78% sometimes sought pharmacists' recommendations regarding their patients' drug therapy. Only 28% of physicians referred their patients to community pharmacists for a medication review, with 44% being unaware such a service exists. Rural physicians were significantly more likely than urban physicians to regularly take community pharmacists' phone calls. Physicians perceived more accurate patient medication lists as the main advantage of collaborating with community pharmacists and pharmacists' lack of patient information, including lab results and diagnosis, as the main disadvantage. Perceived pros of collaboration were positive predictors of physician readiness to collaborate, while perceived cons were negative predictors. Female physicians were more likely than male ones to seek pharmacists' recommendations, while more experienced physicians were more likely to refer patients to pharmacists for a medication review.

Conclusions:

Overall, Ontario physicians were more engaged in low- and mid-level collaborative behaviours with community pharmacists. The most significant predictor of physician readiness to collaborate was perceived advantages of collaboration, while perceived disadvantages were predictive of 2 of the 3 collaborative behaviours. There was some evidence for greater propensity for rural, female, or experienced physicians to collaborate.