Community pharmacy and general practice collaborative and integrated working: a realist review protocol

Area of Science:

• Health Services Research
• Pharmacy Practice
• Primary Care

Background:

• Increasing collaboration between General Practice (GP) and Community Pharmacy (CP) is a UK National Health Service priority.
• Integrated working aims to reduce health system fragmentation and improve care coordination.
• Limited understanding exists on how to achieve and sustain GP-CP collaboration and overcome barriers.

Purpose of the Study:

• To understand the conditions, mechanisms, and contexts for effective collaborative and integrated working between GP and CP.
• To synthesize evidence on how, when, and why GP-CP working arrangements facilitate optimal communication and decision-making.
• To develop a programme theory explaining the success factors and circumstances of GP-CP integrated working.

Main Methods:

• A realist review approach will be employed to synthesize complex evidence.
• Pawson's five iterative stages of realist review will guide the process.
• Evidence from grey literature, qualitative, quantitative, and mixed-methods research will be synthesized.

Main Results:

• The review synthesizes evidence to explain how, for whom, and under which circumstances collaborative working between GP and CP is effective.
• Identifies key facilitators and barriers to integrated care models between primary and community pharmacy settings.
• Develops a programme theory to guide future implementation and research.

Conclusions:

• Effective GP-CP collaboration requires understanding specific contextual factors and mechanisms.
• Addressing regulatory, organizational, and systemic barriers is crucial for successful integration.
• Findings will inform strategies to enhance patient care coordination through improved GP-CP working relationships.