The movement to integrate pharmacists into a primary care team-based settings is growing in countries such as Canada, the United States, the United Kingdom, and Australia. In the province of Ontario in Canada, almost 200 pharmacists have positions within interdisciplinary primary care team settings, including Family Health Teams and Community Health Centers. This article provides a narrative review of the evolving roles of pharmacists working in primary care teams, with a focus on evidence from Ontario, as well as drawing from other jurisdictions around the world. Pharmacists within primary care teams are uniquely positioned to facilitate the expansion of the pharmacist’s scope of practice, through a collaborative care model that leverages, integrates, and transforms the medication expertise of pharmacists into a reliable asset and resource for physicians, as well as improves the health outcomes for patients and optimizes healthcare utilization.
Pharmacist-led medication reviews have been shown to improve medication management, reducing the adverse effects of polypharmacy among older adults. This paper quantitatively examines the medications, medication discrepancies and drug therapy problems of recipients in primary care. A convenience sample of 16 primary care team pharmacists in Ontario, Canada contributed data for patients with whom they conducted a medication review over a prior four-week period. Data were uploaded using electronic data capture forms and descriptive analyses were completed. Two hundred and thirty-seven patients (on average, 67.9 years old) were included in the study, taking an average of 9.2 prescription medications (4.7). Majority of these patients (83.5%) were categorized as polypharmacy patients taking at least five or more prescribed drugs per day. Just over half of the patients were classified as having a low level of medication complexity (52.3%). Pharmacists identified 2.1 medication discrepancies (3.9) and 3.6 drug therapy problems per patient (2.8). Half these patients had more than one medication discrepancy and almost every patient had a drug therapy problem identified. Medication reviews conducted by pharmacists in primary care teams minimized medication discrepancies and addressed drug therapy problems to improve medication management and reduce adverse events that may result from polypharmacy.
5 May 2021 in International Journal of Pharmacy Practice
Objectives: Family Health Teams (FHTs) in Ontario, Canada are interdisciplinary primary healthcare practices where pharmacists engage in patient care including medication and chronic disease management. Methods: Descriptive content analysis was used to examine qualitative responses of FHT pharmacists on their most significant contribution to a patient’s medication management. Key findings: Common roles described included medication management (70.2%), counselling and education (15.5%), monitoring and optimization (11.3%) and administration (3.1%). Chronic conditions addressed were diabetes (39.0%), cardiovascular (22.0%), pain (17.0%) and mental health (11.0%). Conclusions: While FHT pharmacists primarily view themselves as medication management experts, larger roles in counselling, education and chronic disease management are key contributions.
Background. Registered Practical Nurses (RPNs) are considered a critical component of high functioning nursing and interprofessional care teams. Therefore, it is important to ensure that RPNs feel valued within their roles within acute care settings. High acute care demands in tandem with unsupported workplace environments can lead to increased levels of job dissatisfaction, burnout, and ultimately impact retention. Identifying and examining the barriers and facilitators that enable RPNs to be optimally equipped within acute care are critical towards ensuring success in their role. In this study, we explore the experiences of RPNs and perspectives of nurse leaders on RPN integration into an acute care setting. Methods. A mixed method study among RPNs (n = 10) and nurse leaders (n = 10) was conducted. This included administration of the Assessment for Collaborative Environments (ACE‐15) tool to measure interprofessional integration, collaboration, and teamwork. Semi‐structured interviews were also held with all participants to explore both the lived experiences of RPNs in the acute care environment and the perspectives of nurse leaders who had supported the onboarding and integration of RPNs. Results. Our inductive content analysis identified 5 themes: preintegration process, nursing team dynamics, RPN role clarity, challenges to RPN integration, and benefits to RPN integration. ACE‐15 data showed no significant differences in the level of teamness and internal disagreement between RPNs and nurse leaders (t (17) = 0.37 and p = 4.60). RPNs reporting a higher level of teamness described a more positive integration experience than those who reported a lower level of teamness. Conclusion. The integration of a new role to existing teams brings both benefits and challenges which are experienced uniquely by RPNs and nurse leaders. Nurse leaders can utilize findings of this study to better prepare their staff and units for the integration of new roles into their models of care.