Abstract
Background: The optimal use of medicines is a fundamental goal in health policy worldwide. Using medicines effectively and safely relies on a large and constantly increasing knowledge base. Despite living in an era of unprecedented access to information, unmet information needs remain an issue in clinical practice. Pharmacy practice is moving towards increased provision of cognitive services; services which draw on pharmacists’ specialised knowledge to promote safe, effective use of medicines. Making better use of the pharmacist workforce to contribute to improved patient outcomes from medicines use in primary care is a key goal of New Zealand health policy.
Aims: This thesis examines the medicines information needs of general practitioners and the roles of pharmacists in providing medicines information support in New Zealand.
Methods: A mixed methods approach comprising a structured reflection on patient consultations and semi-structured interviews was used to gather data from general practitioners about their medicines information needs. Medicines information provision by pharmacists based in secondary care was investigated using a combination of an electronic survey and semi-structured interviews. An electronic survey explored the information roles of pharmacists practising in the primary care setting.
Results: Two main themes were identified related to general practitioner medicines information needs: the ‘common core’ and the ‘perplexing periphery’. Key factors affecting medicines information resource use by general practitioners were: awareness and accessibility of resources, trust in the resource, presentation of the information, the presence of the patient, and scarcity of time. General practitioners were positive about their relationship with pharmacists, but a limited awareness of the potential and extent of medicines information support roles of pharmacists was apparent. Key factors affecting medicines information provision by pharmacists were: their skill level, their profile with service users, effective intra-professional networks, the availability of information resources, and limitations on time and therefore capacity.
Conclusions: To improve the impact of pharmacists as knowledge mobilisers in primary care, awareness of and trust in pharmacists’ abilities need to be developed. Demonstration of skills and knowledge is important as is a strong intra-professional network to provide support and facilitate access to specialist skills. Medicines information services have the potential to perform a networking function through coordination of information resources and training. Greater integration between primary and secondary care would enable consistent medicines information support for health professionals across New Zealand and contribute to improved outcomes for patients.