Abstract
Background: The University of Otago School of Pharmacy Clinic (the Clinic) is a campus-based non-dispensing Clinic that offers consultation-based medicines optimisation services to patients. Established in 2019, the Clinic is the first facility of its kind in New Zealand. There has been no formative evaluation of the Clinic to date, and little is understood about the experiences of healthcare providers who have referred their patient for a consultation, nor how well the service is meeting their needs.
Objectives: This research aimed to explore referring healthcare providers’ experiences of the Clinic. Specific objectives were to understand; healthcare providers’ motivations for referring their patients to the Clinic, how collaboration with the Clinic impacts providers, patients, and the wider health system, provider satisfaction, and to explore opportunities for improved collaborative practice.
Methods: Semi-structured interviews were used to collect data from 15 participants who represented five health professions: dieticians (n=3), physicians (n=3), nurses (n=3), pharmacists (n=3) and physiotherapists (n=3). Interview recordings were transcribed verbatim. An inductive reflexive thematic analysis approach was used to analyse the dataset from which codes and themes were developed. The Normalization Process Theory (NPT) was used to structure the interview guide and as a framework to present themes within.
Results: Seven themes were developed from the dataset. ‘Perceptions of Pharmacists’ (Coherence), ‘Motivators for Engagement’ and ‘Barriers to Engagement’ (Cognitive Participation), ‘Utility of Pharmacist Feedback’ and ‘Opportunities’ (Collective Action), and ‘Referrers’ Experiences’ and ‘Patient-centred Care’ (Reflexive Action).
Conclusion: Medically complex cases and patients requiring medicines education were most likely to be referred to the Clinic. Healthcare providers were satisfied with the service and described predominantly positive experiences. Engaging with the Clinic presented valuable opportunities for interprofessional collaborative practice and continuing professional education. Negative experiences were associated with delays in communication between the Clinic, patients, and referrers. Patients were thought to benefit from their pharmacist’s clinical expertise, time, patient-centred approach, and subsequent medication and health optimisation. More effective interprofessional collaboration could be supported by contact and interaction between clinic pharmacists and referrers. Integration of Clinic pharmacists into specialist outpatient clinics at Dunedin Hospital may broaden the scope and improve efficiency of their services.