## 4 Discussion
Clearer role definitions and onboarding processes could enhance the integration of GPPs into MDTs, fostering their contributions to chronic disease management. The study highlights a strong need for additional training, particularly in clinical skills such as interpreting blood tests and spirometry. Many participants felt that time constraints in primary care limited opportunities for professional development. This emphasises that ongoing training is essential for pharmacists to manage the complexities of multimorbidity effectively [24]. While GPPs in Northern Ireland do receive training in chronic disease management, the study findings suggest that ongoing development is necessary, particularly in diagnostic skills, evolving guidelines, and clinical decision making confidence. Compared to countries like Canada and the USA, where structured postgraduate clinical training is common before pharmacists enter primary care, Northern Ireland's model places GPPs into primary care roles sooner, which may explain some of the reported gaps in confidence. Investing in structured, hands-on clinical training such as supervised case management, diagnostic skill-building, and interprofessional mentorship could bridge this gap and further enhance GPPs' contributions to chronic disease management. This recommends the importance of equipping pharmacists with advanced skills to meet the demands of modern primary care [25]. Workload emerged as a significant barrier, with GPPs reporting that routine administrative tasks often overshadowed opportunities for direct patient care. This aligns with a report that noted an excessive administrative burden can hinder pharmacists from fully utilising their clinical skills [26]. Reducing non-clinical duties by delegating tasks such as repeat-prescribing to administrative staff or pharmacy technicians could free up GPPs to focus on patient-centred activities. This would improve job satisfaction and enable GPPs to dedicate more time to managing chronic conditions, ultimately enhancing patient outcomes. The GPP workforce in Northern Ireland currently does not include pharmacy technicians, which sets it apart from the rest of the UK where pharmacy technicians are integral to the GPP model. Variability in role integration across practices highlights a critical gap in consistency. While some GPPs reported positive relationships with GPs and nurses, others described frustration due to unclear responsibilities or limited collaboration. This variability reflects that inconsistent integration of pharmacists into MDTs can lead to the underutilisation of their expertise [27]. Clear frameworks and regular team meetings could help standardise the integration process, ensuring GPPs are fully embedded within primary care teams. Joint training sessions and case reviews could further strengthen interprofessional collaboration, enhancing team dynamics and mutual understanding of roles [28]. A significant barrier identified in this study was the lack of public awareness about the GPP role. Most participants reported that patients often confuse GPPs with community pharmacists, limiting the recognition of their clinical capabilities. This may affect patient engagement and understanding in optimising healthcare interventions. Public education campaigns highlighting the unique role of GPPs in managing chronic conditions could improve patient awareness and encourage a greater utilisation of their services. Such efforts would enhance the GPP's impact and strengthen patient-pharmac relationships and trust.