Perspectives of patients in relation to the role of the general practice pharmacist: a systematic review and meta-synthesis of qualitative studies
Authors: Hassan A H F , Barry H E , Hughes C M 
Published: April 2024

Abstract

Introduction
The integration of general practice pharmacists (GPPs) into general practice across the United Kingdom (UK) and internationally has been tested and supported through different initiatives.[1] The intention of this integration was to address issues relating to primary care workforce and workload.[1] However, there is limited evidence available on the views of patients about the GPP role.[1]

Aim
To synthesise qualitative research evidence on patients’ views of the GPP role in general practice.

Methods
A systematic, qualitative meta-synthesis was undertaken. A search of six electronic databases (Medline, Embase, Scopus, Web of Science, IPA and CINAHL) was conducted from the date of inception to May 2023; reference lists of included studies were also reviewed. Inclusion criteria were peer-reviewed studies which addressed the views of patients about the GPP role in general practice, in the English language, had used qualitative methods for data collection and analysis; no date restrictions were applied. Findings and verbatim quotes relevant to patients’ views were extracted. This was followed by applying the thematic synthesis approach of Thomas and Harden to the extracted data.[2] The Critical Appraisal Skills Programme (CASP) checklist was used to assess quality of the included studies.[2] The review protocol was registered with PROSPERO (CRD42023423623).

Results
Eight qualitative studies were included, of which five were conducted in the UK and three in Australia. Most studies used interviews to collect data (n=6). The total number of participants was 139 and sample sizes across studies ranged from 7 to 34. Two main analytical themes were generated. The first theme related to perceptions of the GPP role such as benefits (patients believed the GPP increased their knowledge and adherence to medications, rationalised drug therapy, and improved health outcomes) and challenges (patients felt that because GPPs were only available for specific hours every week and on certain days, this was a disadvantage) for patients. The second theme related to attitudes towards the GPP role such as acceptance (acceptability levels of the GPP and their role in general practice among patients were high and no objections were reported when patients were asked to meet with the GPP) and disappointment (some patients were not happy about the way in which medication review was conducted or its outcome). Overall, included studies demonstrated high methodological quality, meeting all or at least seven of the 10 criteria of the CASP checklist.[2]

Conclusion
The findings have shown that there were benefits and challenges associated with the GPP role, along with acceptance and disappointment. The method adopted (i.e. qualitative meta-synthesis) is considered an essential technique for informing practice, policy, and research in healthcare and pharmacy, and has highlighted patients’ views in this study. However, our searches only retrieved studies published in English. Thus, it is possible that there are relevant studies in other languages which have not been identified. Further work is needed to assess patients’ views on the role of the GPP and how this relationship can be developed.

References
1. Karampatakis GD, Patel N, Stretch G et al. Integration and impact of pharmacists in general practice internationally: A rapid review. Journal of Health Services Research & Policy. 2024;29(1):56-67.
2. Flemming K and Noyes J. Qualitative evidence synthesis: where are we at? International Journal of Qualitative Methods. 2021 Feb 19;20:1609406921993276.