4.4 Article

Task sharing in an interprofessional medication management program - a survey of general practitioners and community pharmacists

Journal

BMC HEALTH SERVICES RESEARCH
Volume 22, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12913-022-08378-4

Keywords

Interprofessional medication management; Medication review; Primary care; Task sharing; Survey

Funding

  1. SHI fund AOK PLUS
  2. ABDA -Federal Union of German Associations of Pharmacists
  3. Association of Statutory Health Insurance Physicians - Saxony
  4. Association of Statutory Health Insurance Physicians -Thuringia
  5. Projekt DEAL

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This study aimed to understand how general practitioners (GPs) and community pharmacists (CPs) share tasks in interprofessional medication management programs (MMP). The results showed that most tasks were performed jointly by GPs and CPs, but there were differences in some tasks. The study suggests that the expertise of both GPs and CPs is needed to effectively implement MMP.
Background Pharmacist-led medication review and medication management programs (MMP) are well-known strategies to improve medication safety and effectiveness. If performed interprofessionally, outcomes might even improve. However, little is known about task sharing in interprofessional MMP, in which general practitioners (GPs) and community pharmacists (CPs) collaboratively perform medication reviews and continuously follow-up on patients with designated medical and pharmaceutical tasks, respectively. In 2016, ARMIN (Arzneimittelinitiative Sachsen-Thuringen) an interprofessional MMP was launched in two German federal states, Saxony and Thuringia. The aim of this study was to understand how GPs and CPs share tasks in MMP when reviewing the patients' medication. Methods This was a cross-sectional postal survey among GPs and CPs who participated in the MMP. Participants were asked who completed which MMP tasks, e.g., checking drug-drug interactions, dosing, and side effects. In total, 15 MMP tasks were surveyed using a 5-point Likert scale ranging from I complete this task alone to GP/CP completes this task alone. The study was conducted between 11/2020 and 04/2021. Data was analyzed using descriptive statistics. Results In total, 114/165 (69.1%) GPs and 166/243 (68.3%) CPs returned a questionnaire. The majority of GPs and CPs reported (i) checking clinical parameters and medication overuse and underuse to be completed by GPs, (ii) checking storage conditions of drugs and initial compilation of the patient's medication including brown bag review being mostly performed by CPs, and (iii) checking side-effects, non-adherence, and continuous updating of the medication list were carried out jointly. The responses differed most for problems with self-medication and adding and removing over-the-counter medicines from the medication list. In addition, the responses revealed that some MMP tasks were not sufficiently performed by either GPs or CPs. Conclusions Both GPs' and CPs' expertise are needed to perform MMP as comprehensively as possible. Future studies should explore how GPs and CPs can complement each other in MMP most efficiently.

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