Ontario family physician readiness to collaborate with community pharmacists on drug therapy management

Abstract 

Background

Empirical evidence suggests that pharmacist-physician collaboration can improve patients' clinical outcomes; however, such collaboration occurs relatively infrequently in the community setting. There has been little research on physicians' perspectives of such collaboration.

Objective

To ascertain Ontario family physician readiness to collaborate with community pharmacists on drug therapy management.

Methods

The survey instrument was based on the transtheoretical model of behavior change. It enquired about 3 physician behaviors that represented low-, mid-, and high-level collaboration with pharmacists. The survey was distributed by fax or mail to a random sample of 848 Ontario family physicians and general practitioners, stratified by practice location (urban/rural).

Results

The response rate was 36%. Most respondents reported conversing with community pharmacists about a patient's drug therapy management 5 or fewer times per week. Eighty-four percent reported that they regularly took community pharmacists' phone calls, whereas 78% reported that they sometimes sought pharmacists' recommendations regarding their patients' drug therapy. Twenty-eight percent reported that they sometimes referred their patients to community pharmacists for medication reviews, with 44% unaware of such a service. There were no differences in physician readiness to engage in any of the 3 collaborative behaviors in urban versus rural settings. More accurate patient medication lists were perceived as the main advantage (pro) of collaborating with community pharmacists and pharmacists' lack of patient information as the main disadvantage (con). Collectively, perceived pros of collaboration were positive predictors of physician readiness to collaborate on all 3 behaviors, whereas perceived cons were negative predictors for the low- and mid-level behaviors. Female physicians were more likely than males to seek pharmacists' recommendations, whereas more experienced physicians were more likely to refer patients to pharmacists for medication reviews.

Conclusions

Overall, Ontario physicians were more engaged in the low- and mid-level collaboration with community pharmacists with respect to drug therapy management. The strongest predictor of physician readiness to collaborate was perceived advantages of collaboration.

Keywords: Pharmacist, Physician, Collaboration, Community, Drug therapy management, Family medicine, Transtheoretical model of behavior change