Pharmaceutical Role Expansion and Developments in Pharmacist-Physician Communication

Area of Science:

• Health Services Research
• Interprofessional Education
• Primary Care Medicine

Background:

• Expanded clinical pharmacist roles in patient-centered medical homes (PCMH) necessitate collaboration with primary care physicians (PCPs).
• PCPs often lack prior experience working directly with pharmacists in integrated care models.
• New pharmacist responsibilities, such as formulary control, add complexity to the interprofessional relationship.

Purpose of the Study:

• To characterize the nature of interprofessional collaboration between clinical pharmacists and PCPs.
• To explore the dynamics of communication, role navigation, and relationship building in PCMH settings.
• To identify factors influencing effective collaboration and potential barriers.

Main Methods:

• Qualitative study employing in-depth, semistructured interviews.
• Conducted with 25 clinical pharmacists and 17 PCPs across seven federally funded hospitals and clinics.
• Thematic analysis of interview data to identify key themes.

Main Results:

• Electronic communication, particularly nonformulary requests, created interprofessional tensions.
• Pharmacists used indirect communication to manage hierarchical dynamics and PCP defensiveness.
• Onsite colocation was preferred for enhancing communication and professional relationships.

Conclusions:

• Effective communication strategies are crucial for patient safety, especially concerning medication use.
• Fostering an environment where all team members can voice concerns is vital for error reduction.
• Addressing institutional communication gaps regarding formulary management and electronic request processes is necessary.