Family physicians’ perceptions of pharmacists prescribing in Alberta

Canadian pharmacists now have prescribing authority and little is documented about the physicians’ perception, experience and relational dynamics evolving around the pharmacists’ prescribing practice. The objective of this study was to explore Albertan family physicians’ perceptions and experiences of pharmacists’ prescribing practice. We used purposeful and maximum variation sampling method and semi-structured face to face or telephone interviews to collect data. From October 2014 to February 2016, we interviewed 12 family physicians in Alberta, having experience with pharmacist prescribing. Interviews were audio recorded and transcribed verbatim for analysis using an interpretive description method, guided by “Relational Coordination” theory. NVivo software was used to manage the data. Three key beliefs (i.e., renewal versus initiate new prescription, community versus team pharmacists, and “I am responsible”) about pharmacist prescribing were identified. Trust and communication were prominent themes which shaped participants‘ collaboration with pharmacist prescribers. Participants were classified as either “collaborative” or “consultative”. Participants had greater collaboration with the team pharmacist prescribers compared to community pharmacists due to a higher level of trust and ease of communication. Renewal prescribing by any pharmacist was well accepted but participants showed hesitancy in accepting pharmacist-initiated prescriptions. Our findings provide insight into interprofessional collaboration and communication between physician and pharmacist prescribers.

目前加拿大药剂师已获得处方权，但围绕药剂师处方实践所形成的医师认知、从业体验与关系动态的相关文献记载仍较为匮乏。本研究旨在探究阿尔伯塔省家庭医师对药剂师处方实践的认知与从业体验。本研究采用目的性最大变异抽样法，并通过半结构化面对面访谈或电话访谈收集数据。2014年10月至2016年2月期间，我们访谈了阿尔伯塔省12名拥有药剂师处方实践合作经验的家庭医师。访谈内容以音频录制并逐字转录，随后采用以关系协调（Relational Coordination）理论为指导的解释性描述法开展分析，研究使用NVivo软件对数据进行管理。本研究明确了医师对药剂师处方实践的三类核心认知：即续方与新开处方、社区药剂师与团队药剂师、责任归属。信任与沟通是影响参与者与药剂师处方者合作关系的核心主题。参与者被划分为‘协作型’与‘咨询型’两类。相较于社区药剂师，参与者与团队药剂师处方者的协作程度更高，这源于双方更高的信任水平与更顺畅的沟通体验。各类药剂师开展的续方服务均获得了参与者的广泛认可，但参与者对药剂师发起的新开处方则表现出犹豫态度。本研究结果为医师与药剂师处方者之间的跨专业协作与沟通提供了新的认知视角。