Community pharmacist networks of patient care - collaborating across and beyond boundaries

Community pharmacists are essential collaborators in patient care, yet their professional networks outside geographically co-located teams remain understudied. We adopted a qualitative social network analysis approach to understand how pharmacists establish and maintain relationships to provide interprofessional care. Ego-network data were collected using a two-stage participant-aided concentric circle technique. Participants in a Canadian province who had practiced at least 1 year in community pharmacy identified network members and positioned them according to relative relationship strength. Semi-structured interviews explored participants' rationale for network placement and experiences of collaboration. Thirty pharmacists described networks of varying size and composition. Prescribing professionals, including physicians and nurse practitioners, were frequent collaborators, but patients, their families, and other pharmacists often occupied the closest network circle. Networks were formed and maintained through shared patient care, regular interactions, and social connections, but workforce shortages and time constraints challenged effective collaboration. Relationships were strengthened when members could efficiently communicate and exchange patient information. These findings indicate community pharmacists cultivate varied and dynamic networks to coordinate care across distributed settings. Responsiveness, reciprocity, and boundary-spanning work enable pharmacists to enact interprofessional care beyond formal teams. Recognizing these relational mechanisms may help strengthen community-based connections.