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The development of a role description and competency map for pharmacists in an interprofessional care setting

  • Helen BensonEmail author
  • Cherie Lucas
  • Shalom I. Benrimoj
  • Kylie A. Williams
Review Article
  • 22 Downloads

Abstract

Background Pharmacists are increasingly being included as members of general practice primary care teams. To date, there have been few published studies describing the competencies of general practice (GP) pharmacists and establishing their subsequent educational needs. Aim of the review The aim of this literature review is to establish the activities of pharmacists in general practice to inform the development of a comprehensive role description and competency map. Method A systematic literature search of EMBASE, MEDLINE, international pharmaceutical abstracts and the Cochrane database of systematic reviews was conducted from the start of the databases to August 2018. The search focused on studies investigating the roles performed by GP pharmacists. Full text peer-reviewed English language articles were included. A qualitative content analysis of included studies was performed. Two researchers reviewed studies to identify pharmacist roles. Subcategories of roles were then agreed by the research team and used to present the data. GP pharmacist’s activities were mapped by two researchers to associated competencies. Any discrepancies between role descriptions and competency maps were resolved in consultation with a third member of the research team. Results The search conducted resulted in 5370 potential articles. Two hundred and twenty-seven full text articles were selected for review resulting in 34 articles that were included for analysis. Seven GP pharmacist role sub-categories and 48 GP pharmacist individual roles were identified. The seven GP pharmacist role sub-categories included medication management, patient examination and screening, chronic disease management, drug information and education, collaboration and liaison, audit and quality assurance and research. All FIP competency domains were included in the GP pharmacist competency map. Competencies related to compounding, dispensing and packaging of medications were not found relevant to the GP Pharmacist role. No roles were mapped to competencies relating to re-imbursement for medicines, procurement, or medication production. All areas of professional and personal competence were relevant to the GP pharmacist role. Conclusion A comprehensive role description and competency map for GP pharmacists is described and may be used to inform future research into the education of GP pharmacists.

Keywords

Australia Collaborative care General practice pharmacist Integrated care Interprofessional care Non-dispensing pharmacist 

Notes

Acknowledgements

The authors would like to acknowledge the support and assistance provided by Ms Nerida Croker (NC) Project Officer for the WentWest General Practice Pharmacist Project in mapping GP pharmacist roles to associated competencies.

Funding

Author one (HB) is supported by an Australian Government Research and Training Grant. This research was funded by the Western Sydney Primary Health Network (Project ID PRO 17-4279)

Conflicts of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

References

  1. 1.
    Tan EC, Stewart K, Elliott RA, George J. Pharmacist services provided in general practice clinics: a systematic review and meta-analysis. Res Soc Adm Pharm. 2014;10(4):608–22.Google Scholar
  2. 2.
    Hazen ACM, de Bont AA, Boelman L, Zwart DLM, de Gier JJ, de Wit NJ, et al. The degree of integration of non-dispensing pharmacists in primary care practice and the impact on health outcomes: a systematic review. Res Soc Adm Pharm. 2018;14(3):228–40.Google Scholar
  3. 3.
    Anderson C, Zhan K, Boyd M, Mann C. The role of pharmacists in general practice: a realist review. Res Soc Adm Pharm. 2018.  https://doi.org/10.1016/j.sapharm.2018.06.001.Google Scholar
  4. 4.
    Benson H, Sabater-Hernández D, Benrimoj SI, Williams KA. Piloting the integration of non-dispensing pharmacists in the Australian general practice setting: a process evaluation. Int J Integr Care. 2018;18(2):1–9.Google Scholar
  5. 5.
    Koster A, Schalekamp T, Meijerman I. Implementation of competency-based pharmacy education (CBPE). Pharmacy. 2017;5(1):10.Google Scholar
  6. 6.
    Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376(9756):1923–58.Google Scholar
  7. 7.
    Gruppen LD, Mangrulkar RS, Kolars JC. The promise of competency-based education in the health professions for improving global health. Hum Resour Health. 2012;10(1):43.Google Scholar
  8. 8.
    Anderson C, Bates I, Brock T, Brown AN, Bruno A, Futter B, et al. Needs-based education in the context of globalization. Am J Pharm Educ. 2012;76:56.Google Scholar
  9. 9.
    Frank JR, Snell LS, Cate OT, Holmboe ES, Carraccio C, Swing SR, et al. Competency-based medical education: theory to practice. Med Teach. 2010;32(8):638–45.Google Scholar
  10. 10.
    Pharmaceutical Society of Australia. General practice pharmacist sample scope of practice; 2016. https://my.psa.org.au/s/article/General-Practice-PharmacistSample-Scope-of-Practice-2016. Accessed 19 Sept 2018.
  11. 11.
    Royal Pharmaceutical Society. RPS practice-based-pharmacist-job-specification: royal pharmaceutical society; 2015. https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Policy%20statements/practice-based-pharmacist-job-spec-final.pdf?ver=2016-10-13-101708-230. Accessed 19 Sept 2018.
  12. 12.
    Kennie-Kaulbach N, Farrell B, Ward N, Johnston S, Gubbels A, Eguale T, et al. Pharmacist provision of primary health care: a modified Delphi validation of pharmacists’ competencies. BMC Fam Pract. 2012;13:27.Google Scholar
  13. 13.
    Farrell BBPF, Ward NMA, Kennie NBP, Jorgenson DBSPP, Tewodros EMDM, Dolovich LBPM, et al. Validating primary health care pharmacist competencies: checking our aim. Can Pharm J. 2011;144(5):1.Google Scholar
  14. 14.
    Saseen JJ, Ripley TL, Bondi D, Burke JM, Cohen LJ, McBane S, Vande Griend JP. ACCP clinical pharmacist competencies. Pharmacotherapy. 2017;37(5):630–6.  https://doi.org/10.1002/phar.1923.Google Scholar
  15. 15.
    Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med. 2009;151(4):W65–94.Google Scholar
  16. 16.
    Sandelowski M, Leeman J, Knafl K, Crandell JL. Text-in-context: a method for extracting findings in mixed-methods mixed research synthesis studies. J Adv Nurs. 2013;69(6):1428–37.Google Scholar
  17. 17.
    Haggarty L. What is… content analysis? (article). Med Teach. 1996;18(2):9.Google Scholar
  18. 18.
    Holdford D. Content analysis methods for conducting research in social and administrative pharmacy. Res Soc Adm Pharm. 2008;4(2):173–81.Google Scholar
  19. 19.
    Federation Internationale Pharmaceutique. Pharmacy Education Taskforce a Global Competency Framework Version 1. 2012(1) Available at https://www.fip.org/files/fip/PharmacyEducation/GbCF/GbCF_v1_online_A4.pdf. Accessed 11 Mar 2019.
  20. 20.
    Stupans I, Atkinson J, Mestrovic A, Nash R, Rouse MJ. A shared focus: comparing the Australian, Canadian, United Kingdom and United States pharmacy learning outcome frameworks and the global competency framework. Pharmacy (Basel). 2016;4(3):1–9.Google Scholar
  21. 21.
    Otaguro JE, Kruse LE. Assessment of drug-prescribing problems in a multidisciplinary primary care clinic. J Pharm Technol. 1996;12(4):155–9.Google Scholar
  22. 22.
    Nigro SC, Garwood CL, Berlie H, Irons B, Longyhore D, McFarland MS, et al. Clinical pharmacists as key members of the patient-centered medical home: an opinion statement of the Ambulatory Care Practice and Research Network of the American College of Clinical Pharmacy. Pharmacotherapy. 2014;34(1):96–108.Google Scholar
  23. 23.
    Boudreau DM, Capoccia KL, Sullivan SD, Blough DK, Ellsworth AJ, Clark DL, et al. Collaborative care model to improve outcomes in major depression. Ann Pharmacother. 2002;36(4):585–91.Google Scholar
  24. 24.
    Gerber BS, Rapacki L, Castillo A, Tilton J, Touchette DR, Mihailescu D, et al. Design of a trial to evaluate the impact of clinical pharmacists and community health promoters working with African-Americans and latinos with diabetes. BMC Public Health. 2012;12(1):891.Google Scholar
  25. 25.
    Musselman KT, Moczygemba LR, Pierce AL, Plum M-BF, Brokaw DK, Kelly DL. Development and implementation of clinical pharmacist services within an integrated medical group. J Pharm Pract. 2015;30(1):75–81.Google Scholar
  26. 26.
    Sisson EM, Dixon DL, Kildow DC, Van Tassell BW, Carl DE, Varghese D, et al. Effectiveness of a pharmacist-physician team-based collaboration to improve long-term blood pressure control at an inner-city safety-net clinic. Pharmacotherapy. 2016;36(3):342–7.Google Scholar
  27. 27.
    Smith MC, Boldt AS, Walston CM, Zillich AJ. Effectiveness of a pharmacy care management program for veterans with dyslipidemia. Pharmacotherapy. 2013;33(7):736–43.Google Scholar
  28. 28.
    Benedict ASM, Sie J, Chin H, Ngo C, Salmingo J, Vidaurreta A, Rashid N. Evaluation of a pharmacist-managed diabetes program in a primary care setting within an integrated health care system. J Manag Care Spec Pharm. 2018;24(2):114–22.Google Scholar
  29. 29.
    Carter BL, Helling DK, Jones ME, Moessner H, Waterbury CA. Evaluation of family physician prescribing: influence of the clinical pharmacist. Drug Intell Clin Pharm. 1984;18(10):817–21.Google Scholar
  30. 30.
    Heilmann RMF, Campbell SM, Kroner BA, Proksel JR, Billups SJ, Witt DM, et al. Evolution, current structure, and role of a primary care clinical pharmacy service in an integrated managed care organization. Ann Pharmacother. 2013;47(1):124–31.Google Scholar
  31. 31.
    Barker EA, Pond ST, Zaiken K. Impact of medication onboarding: a clinical pharmacist-run “onboarding” telephone service for patients entering a primary care practice. J Pharm Technol. 2015;32(1):9–15.Google Scholar
  32. 32.
    Weidman-Evans E, Evans J, Eastwood R, Fort A. Implementation of a pharmacist-run telephonic insulin titration service. J Am Pharm Assoc (2003). 2012;52(6):e266–72.Google Scholar
  33. 33.
    Kennedy AG, Chen H, Corriveau M, MacLean CD. Improving population management through pharmacist-primary care integration: a pilot study. Popul Health Manag. 2015;18(1):23–9.Google Scholar
  34. 34.
    Joseph T HG, Eltaki S, Prados Y, Jones R, Seamon M, Moreau C, Gernant S. Integration strategies of pharmacists in primary care-based accountable care organizations: a report from the accountable care organization research network, services, and education. J Manag Care Spec Pharm. 2017;23(5):541–48.Google Scholar
  35. 35.
    Choe HM, Farris KB, Stevenson JG, Townsend K, Diez HL, Remington TL, et al. Patient-centered medical home: developing, expanding, and sustaining a role for pharmacists. Am J Health Syst Pharm. 2012;69(12):1063–71.Google Scholar
  36. 36.
    Manolakis PG, Skelton JB. Pharmacists’ contributions to primary care in the United States collaborating to address unmet patient care needs: the emerging role for pharmacists to address the shortage of primary care providers. Am J Pharm Educ. 2010;74:S7.Google Scholar
  37. 37.
    Albanese NP, Pignato AM, Monte SV. Provider perception of pharmacy services in the patient-centered medical home. J Pharm Pract. 2016;30(6):612–20.Google Scholar
  38. 38.
    Woodall T, Landis SE, Galvin SL, Plaut T, Roth McClurg MT. Provision of annual wellness visits with comprehensive medication management by a clinical pharmacist practitioner. Am J Health Syst Pharm. 2017;74(4):218–23.Google Scholar
  39. 39.
    Cawley MJ, Moon J, Reinhold J, Willey VJ, Warning Ii WJ. Spirometry: tool for pharmacy practitioners to expand direct patient care services. J Am Pharm Assoc (2003). 2013;53(3):307–15.Google Scholar
  40. 40.
    Johnson KA, Chen S, Cheng IN, Lou MM, McCombs J. The impact of clinical pharmacy services integrated into medical homes on diabetes-related clinical outcomes. Ann Pharmacother. 2010;44(12):1877–86.Google Scholar
  41. 41.
    Smith M, Bates DW, Bodenheimer TS. Pharmacists belong in accountable care organizations and integrated care teams. Health Aff (Millwood). 2013;32(11):1963–70.Google Scholar
  42. 42.
    Tan E, Stewart K, Elliott RA, George J. An exploration of the role of pharmacists within general practice clinics: the protocol for the pharmacists in practice study (PIPS). BMC Health Serv Res. 2012;12:246.Google Scholar
  43. 43.
    Freeman C, Cottrell WN, Kyle G, Williams I, Nissen L. Integrating a pharmacist into the general practice environment: opinions of pharmacist’s, general practitioner’s, health care consumer’s, and practice manager’s. BMC Health Serv Res. 2012;12(1):229.Google Scholar
  44. 44.
    Tan EC, Stewart K, Elliott RA, George J. Integration of pharmacists into general practice clinics in Australia: the views of general practitioners and pharmacists. Int J Pharm Pract. 2014;22(1):28–37.Google Scholar
  45. 45.
    Develin A. Pharmacists in general practice—ACT pilot program: my journey so far. J Pharm Pract Res. 2017;47(4):308–12.Google Scholar
  46. 46.
    Freeman C, Cottrell N, Rigby D, Williams ID, Nissen L. The Australian practice pharmacist. J Pharm Pract Res. 2014;44(4):240–8.Google Scholar
  47. 47.
    Stone MC, Williams HC. Clinical pharmacists in general practice: value for patients and the practice of a new role. Br J Gener Pract. 2015;65(634):262–3.Google Scholar
  48. 48.
    Barnes EAI, Din A. New roles for clinical pharmacists in general practice. Prescriber. 2017;2017:26–9.Google Scholar
  49. 49.
    Chen J, Britten N. ‘Strong medicine’: an analysis of pharmacist consultations in primary care. Fam Pract. 2000;17(6):480–3.Google Scholar
  50. 50.
    Bradley F, Seston E, Mannall C, Cutts C. Evolution of the general practice pharmacist’s role in England: a longitudinal study. Br J Gen Pract. 2018;68(675):e727–34.Google Scholar
  51. 51.
    Ryan K, Patel N, Lau WM, Abu-Elmagd H, Stretch G, Pinney H. Pharmacists in general practice: a qualitative interview case study of stakeholders’ experiences in a West London GP federation. BMC Health Serv Res. 2018;18(1):234.Google Scholar
  52. 52.
    Kolodziejak L, Remillard A, Neubauer S. Integration of a primary healthcare pharmacist. J Interprof Care. 2010;24:274–84.Google Scholar
  53. 53.
    Farrell B, Ward N, Dore N, Russell G, Geneau R, Evans S. Working in interprofessional primary health care teams: what do pharmacists do? Res Soc Adm Pharm. 2013;9(3):288–301.Google Scholar
  54. 54.
    Mendonça SdAM, Melo AC, Pereira GCC, Santos DMdSSd, Grossi EB, Sousa MdCVB, et al. Clinical outcomes of medication therapy management services in primary health care. Braz J Pharm Sci. 2016;52(3):365–73.Google Scholar
  55. 55.
    Gilani F, Majumdar SR, Johnson JA, Tsuyuki RT, Lewanczuk RZ, Spooner R, et al. Adding pharmacists to primary care teams increases guideline-concordant antiplatelet use in patients with type 2 diabetes: results from a randomized trial. Ann Pharmacother. 2013;47(1):43–8.Google Scholar
  56. 56.
    Hazen AC, Sloeserwij VM, Zwart DL, de Bont AA, Bouvy ML, de Gier JJ, et al. Design of the POINT study: pharmacotherapy optimisation through integration of a non-dispensing pharmacist in a primary care team (POINT). BMC Fam Pract. 2015;16:76.Google Scholar
  57. 57.
    Dolovich L, Pottie K, Kaczorowski J, Farrell B, Austin Z, Rodriguez C, et al. Integrating family medicine and pharmacy to advance primary care therapeutics. Clin Pharmacol Ther. 2008;83(6):913–7.Google Scholar
  58. 58.
    Jorgenson D, Dalton D, Farrell B, Tsuyuki R, Dolovich L. Guidelines for pharmacists integrating into primary care teams. CPJ/RPC. 2013;146:342–52.Google Scholar
  59. 59.
    Trinacty M, Farrell B, Schindel TJ, Sunstrum L, Dolovich L, Kennie N, et al. Learning and networking: utilization of a primary care listserv by pharmacists. Can J Hosp Pharm. 2014;67(5):343–52.Google Scholar
  60. 60.
    Elliott RA, Putman K, Franklin M, Verhaeghe N, Annemans L, Eden M, et al. Determining economic impact of a pharmacist-led it-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices (pincer). Value Health. 2013;16(3):A206.Google Scholar
  61. 61.
    Geurts MM, Talsma J, Brouwers JR, de Gier JJ. Medication review and reconciliation with cooperation between pharmacist and general practitioner and the benefit for the patient: a systematic review. Br J Clin Pharmacol. 2012;74(1):16–33.Google Scholar
  62. 62.
    Law MRP, Ma T, Fisher JP, Sketris ISPMPA. Independent pharmacist prescribing in Canada. Can Pharm J. 2012;145(1):17–23E1.Google Scholar
  63. 63.
    Bourne RS, Baqir W, Onatade R. Pharmacist independent prescribing in secondary care: opportunities and challenges. Int J Clin Pharm. 2016;38(1):1–6.Google Scholar
  64. 64.
    Raghunandan R, Tordoff J, Smith A. Non-medical prescribing in New Zealand: an overview of prescribing rights, service delivery models and training. Ther Adv Drug Saf. 2017;8(11):349–60.Google Scholar
  65. 65.
    Hale A, Coombes I, Stokes J, Aitken S, Clark F, Nissen L. Patient satisfaction from two studies of collaborative doctor-pharmacist prescribing in Australia. Health Expect. 2016;19(1):49–61.Google Scholar
  66. 66.
    McKeirnan KC, Akers JM, Czapinski JC, Robinson JD. Using collaborative drug therapy agreements to train student pharmacists to provide clinical patient care services. Am J Pharm Educ. 2017;81(2):1–8.Google Scholar
  67. 67.
    McConeghy KW, Wing C. A national examination of pharmacy-based immunization statutes and their association with influenza vaccinations and preventive health. Vaccine. 2016;34(30):3463–8.Google Scholar
  68. 68.
    Hattingh L. Pharmacy legal: pharmacist immunisation services. Aust Pharmacist. 2015;34(4):72–3.Google Scholar
  69. 69.
    Woolf R, Locke A, Potts C. Pharmacist prescribing within an integrated health system in Washington. Am J Health Syst Pharm. 2016;73(18):1416–24.Google Scholar
  70. 70.
    Isenor JE, Edwards NT, Alia TA, Slayter KL, MacDougall DM, McNeil SA, Bowles SK. Impact of pharmacists as immunizers on vaccination rates: a systematic review and meta-analysis. Vaccine. 2016;34(47):5708–23.  https://doi.org/10.1016/j.vaccine.2016.08.085.Google Scholar
  71. 71.
    Ripley TL, Adamson PB, Hennebry TA, Van Tuyl JS, Harrison DL, Rathbun RC. Collaborative practice model between cardiologists and clinical pharmacists for management of patients with cardiovascular disease in an outpatient clinic. Ann Pharmacother. 2013;48(3):412–9.Google Scholar
  72. 72.
    Leal S, Soto M. Pharmacists disease state management through a collaborative practice model. J Health Care Poor Underserved. 2005;16(2):220–4.Google Scholar
  73. 73.
    Cohen H. Pharmacists and collaborative drug therapy management in New York State. J Pharm Pract. 2011;24(6):582–3.Google Scholar
  74. 74.
    Moreno G, Lonowski S, Fu J, Chon JS, Whitmire N, Vasquez C, et al. Physician experiences with clinical pharmacists in primary care teams. J Am Pharm Assoc. 2017;57(6):686–91.Google Scholar
  75. 75.
    Jorgenson D, Laubscher T, Lyons B, Palmer R. Integrating pharmacists into primary care teams: barriers and facilitators. Int J Pharm Pract. 2014;22(4):292–9.Google Scholar
  76. 76.
    Patterson BJ, Solimeo SL, Stewart KR, Rosenthal GE, Kaboli PJ, Lund BC. Perceptions of pharmacists’ integration into patient-centered medical home teams. Res Soc Adm Pharm. 2015;11(1):85–95.Google Scholar
  77. 77.
    Körner M, Bütof S, Müller C, Zimmermann L, Becker S, Bengel J. Interprofessional teamwork and team interventions in chronic care: a systematic review. J Interprof Care. 2016;30(1):15–28.Google Scholar
  78. 78.
    Boyle M, Myford C. Pharmacists’ expectations for entry-level practitioner competency. Am J Pharm Educ. 2013;77:1.  https://doi.org/10.1186/1472-6963-12-246.Google Scholar

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Authors and Affiliations

  1. 1.Graduate School of HealthUniversity of Technology SydneySydneyAustralia
  2. 2.Sydney Pharmacy SchoolThe University of Sydney AustraliaSydneyAustralia

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