445 GPs’ perceptions of pharmacists working in general practices in Ireland: a cross-sectional survey
Authors: Hurley E , Foley T , Walsh E , Byrne S , Dalton K 
Published: April 2023

Abstract

Introduction
Pharmacists are increasingly incorporated into general practice teams globally, and in such positions have been shown to enhance patient outcomes. However, there is limited research to date on determining general practitioners’ (GPs’) perceptions of practice pharmacists in countries where this role has yet to be established, such as Ireland, and it is also unclear how GP and practice characteristics may affect future integration.

Aim
To explore GPs’ perceptions towards integrating pharmacists into practices in Ireland and determine if any significant associations were present between GPs’ perceptions and their demographic characteristics.

Methods
The survey was constructed based on the findings from a qualitative evidence synthesis (1) and an interview study that utilised the Theoretical Domains Framework (2). In June 2022, the survey was disseminated to a random sample of 500/842 GPs in Munster, Ireland via post and also through Twitter, WhatsApp, and an online GP support and education network. Quantitative data were captured through multiple option, ranking, binary, and Likert scale questions, and analysed using descriptive and inferential statistics. Post-hoc analysis was performed using the z-test to compare column proportions; adjustment for multiple testing using the Bonferroni method was also conducted. Differences were considered statistically significant where p&lt;0.05. Qualitative data were captured by use of free-text boxes and analysed using reflexive thematic analysis.

Results
In total, 152 valid responses were received (24.6% response to postal survey). GPs were broadly welcoming and optimistic about the future role of a general practice-based pharmacist. Nearly all respondents agreed with practice pharmacists providing medicines information (98%) versus 47%, 42%, and 23% agreeing with practice pharmacists vaccinating, managing minor ailments, and independent prescribing respectively. The three most frequently agreed-with outcomes of having a practice pharmacist were improved access to medicines information (92%), increased patient safety (90%), and increased adherence to clinical guidelines (85%). GPs in large practices were more likely to select the optimal frequency of pharmacist presence in practices as 1-2 days per week compared to those in small/medium-size practices (70% versus 40/45%; p&lt;0.05). Most (78.6%) agreed they would partake in a practice pharmacist pilot; GPs who approved of pharmacists performing independent prescribing were significantly more likely to agree with this (p&lt;0.05). When GPs were asked if the potential outcomes of practice pharmacists justified the theoretical cost of employing them, 48.6% agreed and 24.7% disagreed. Most thought practice pharmacists being fully funded by the government was most feasible (84.6%). The GPs’ free-text comments were synthesised into five overarching themes, which describe the current pressures in general practice, the utility of pharmacists and possibility of expanding their roles, funding and governance, practice pharmacist roles, and anticipated outcomes.

Conclusion
Although limited by a somewhat low response rate, this theory-informed survey study provides a deeper understanding of GPs’ perceptions of integrating pharmacists into practices. With these findings showing that most GPs perceive positive outcomes with practice pharmacists, policymakers should allocate funding to these roles in Ireland, coupled with robust cost-effectiveness analyses, to better demonstrate the impact that these novel pharmacist roles can have on primary care health service provision.

References
1. Hurley E, Gleeson LL, Byrne S, Walsh E, Foley T, Dalton K. General practitioners’ views of pharmacist services in general practice: a qualitative evidence synthesis. Family Practice. 2022 Aug 1;39(4):735–46.
2. Hurley E, Walsh E, Foley T, Heinrich CH, Byrne S, Dalton K. General practitioners’ perceptions of pharmacists working in general practice: a qualitative interview study. Family Practice. 2022 Oct 15