Pharmacist integration into the medical home: qualitative analysis

To determine the acceptance and attitudes of family medicine physicians, clinical and nonclinical office staff, pharmacists, and patients during pharmacist integration into a medical home.

Qualitative study.

Pittsburgh, PA, area from August 2009 to June 2010.

Physicians, staff, pharmacists, and patients at four single-specialty family medicine office practices functioning as medical homes.

Attitudes, acceptance, barriers, and problems identified by participants.

A total of 84 interviews were conducted: 21 interviews with family medicine physicians, 26 with patient care staff, 9 with nonclinical staff, 13 with patients, 6 with pharmacists, and 8 with office managers. Five main themes emerged from each group regarding the integration of a pharmacist, including positive overall feeling; clinical, educational, and time-saving benefits to the various groups; challenges understanding the role of the pharmacist; improved workflow and integration resulting from pharmacist flexibility and motivation; and suggestions to increase the pharmacists' time in each office. Pharmacists felt that they were accepted within 6 months of the integration process and that time management was a challenge.

Participants felt that inclusion of a pharmacist into their practice improves the quality of patient care, provides a valuable resource for all providers and staff, and empowers patients. The initial concerns of the clinical and nonclinical staff disappeared within the first months of pharmacist integration. These results provide guidance to clinicians and insight into strategies for building a pharmacist-integrated medical home team.