Evaluating Models of Pharmacist Integration into General Practice in New Zealand

Background: Internationally, pharmacists are increasingly being integrated into general practice. The practice pharmacist role is underdeveloped in Aotearoa New Zealand (NZ), and there is a paucity of information about how the role is operationalised in practice. Aim: This research aimed to ascertain how pharmacists are currently integrated into general practice in NZ, and what factors can affect the role becoming more widespread in the future. Methods: This research, framed in a pragmatic paradigm, employed an explanatory, sequential, mixed-methods research design to address the research aim. This included: a narrative review of the NZ health system; a narrative review of the journey towards widespread integration of pharmacists into general practice in England; an online survey distributed to all NZ pharmacists; and a collective case study investigation across six general practice sites. Q methodology was used to further elucidate stakeholder views on the research topic. Results: Pharmacist integration into general practice in NZ is not widespread and largely localised to particular regions across the country. In the absence of a formal national contracting framework, various commissioning models have been established by local health authorities. Practice pharmacists were typically patient-facing, completing clinical activities such as medication reviews, managing long-term conditions, and medicines reconciliation. Having prescribing rights was generally seen as an enabler for the role. Practice staff were often cautious when a pharmacist first started in the practice, primarily due to unfamiliarity with the role and skillset of pharmacists. However, this quickly dissipated and staff and patients quickly came to recognise the value of the practice pharmacist. Stakeholders identified three unique models describing how pharmacists could be integrated into general practice. Consensus was reached with respect to views on the role’s value and the need for additional funding and support. However, models diverged significantly regarding views on community pharmacy and practice pharmacist role scope and independence. Conclusion: Pharmacist integration into general practice in NZ has progressed slowly, however, the NZ health system reforms may promote more widespread integration. The findings from this research can be used to help ensure that commissioning and operational arrangements for practice pharmacists are successful.

Name thesis:degree_name

PhD

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Pharmacy

Grantor dc:publisher

ResearchSpace@Auckland

Year dc:date.issued

2023

Author dc:creator

• Haua, Robert James

Advisors dc:contributor.advisor

• Aspden, Trudi
• Harrison, Jeff

Statement dc:rights

• Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Licence dc:rights.uri

• https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm

Handle dc:identifier.uri

https://hdl.handle.net/2292/64645

OAI identifier oai:identifier

oai:researchspace.auckland.ac.nz:2292/64645