Marques Iuri, Gray Nicola Jane, Tsoneva Jo, Magirr Peter, Blenkinsopp Alison
Senior Research Fellow in Safe Use of Medicines, School of Pharmacy and Medical Sciences, University of Bradford, Bradford, UK.
Independent Pharmacist Researcher, Green Line Consulting Limited, Manchester, UK.
BJGP Open. 2018 Oct 17;2(4):bjgpopen18X101611. doi: 10.3399/bjgpopen18X101611. eCollection 2018 Dec.
The NHS in the UK supports pharmacists' deployment into general practices. This article reports on the implementation and impact of the Primary Care Pharmacy Programme (PCPP). The programme is a care delivery model that was undertaken at scale across a city in which community pharmacists (CPs) were matched with general practices and performed clinical duties for one half-day per week.
To investigate (a) challenges of integration of CPs in general practices, and (b) the perceived impact on care delivery and community pharmacy practice.
DESIGN & SETTING: This mixed-methods study was conducted with CPs, community pharmacy employers (CPEs), scheme commissioners (SCs), and patients in Sheffield.
Semi-structured interviews ( = 22) took place with CPs ( = 12), CPEs ( = 2), SCs ( = 3), and patients ( = 5). A cross-sectional survey of PCPP pharmacists ( = 47, 66%) was also used. A descriptive analysis of patient feedback forms was undertaken and a database of pharmacist activities was created.
Eighty-six of 88 practices deployed a pharmacist. Although community pharmacy contracting and backfill arrangements were sometimes complicated, timely deployment was achieved. Development of closer relationships appeared to facilitate extension of initially agreed roles, including transition from 'backroom' to patient-facing clinical work. CPs gained understanding of GP processes and patients' primary care pathway, allowing them to follow up work at the community pharmacy in a more timely way, positively impacting on patients' and healthcare professionals' perceived delivery of care.
The PCPP scheme was the first of its kind to achieve almost universal uptake by GPs throughout a large city. The study findings reveal the potential for CP-GP joint-working in increasing perceived positive care delivery and reducing fragmented care, and can inform future implementation at scale and at practice level.
英国国家医疗服务体系（NHS）支持药剂师进入全科医疗诊所工作。本文报告了初级保健药房计划（PCPP）的实施情况及其影响。该计划是一种护理提供模式，在一个城市范围内大规模开展，社区药剂师（CPs）与全科医疗诊所进行配对，并每周进行半天的临床工作。
调查（a）社区药剂师融入全科医疗诊所的挑战，以及（b）对护理提供和社区药房实践的感知影响。
本混合方法研究在谢菲尔德与社区药剂师、社区药房雇主（CPEs）、计划专员（SCs）和患者开展。
对社区药剂师（n = 12）、社区药房雇主（n = 2）、计划专员（n = 3）和患者（n = 5）进行了22次半结构化访谈。还对PCPP药剂师进行了横断面调查（n = 47，66%）。对患者反馈表进行了描述性分析，并创建了药剂师活动数据库。
88家诊所中有86家配备了药剂师。尽管社区药房签约和替补安排有时很复杂，但仍实现了及时部署。建立更紧密的关系似乎有助于扩展最初商定的角色范围，包括从“幕后”工作向面向患者的临床工作的转变。社区药剂师了解了全科医生（GP）的工作流程和患者的初级保健途径，使他们能够更及时地跟进社区药房的工作，对患者和医疗专业人员感知到护理提供产生了积极影响。
PCPP计划是同类计划中首个在一个大城市中几乎被所有全科医生采用的计划。研究结果揭示了社区药剂师与全科医生联合工作在提高护理提供感知积极性和减少护理碎片化方面的潜力，并可为未来大规模和实践层面的实施提供参考。
