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General practice / Family practice
Original research
Pharmacist-led adherence support in general practice: a qualitative interview study of adults with asthma
  1. Marissa Ayano Mes1,
  2. Caroline Brigitte Katzer1,
  3. Vari Wileman1,
  4. Amy Hai Yan Chan1,
  5. Robert Horne1,
  6. Stephanie Jane Caroline Taylor2
  1. 1 Centre for Behavioural Medicine, Research Department of Practice and Policy, UCL School of Pharmacy, London, UK
  2. 2 Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, London, UK
  1. Correspondence to Professor Stephanie Jane Caroline Taylor; s.j.c.taylor{at}qmul.ac.uk

Abstract

Objectives The National Health Service (NHS) in England recently introduced general practice pharmacists (GPPs) to provide medication-focused support to both patients and the general practice team. This healthcare model may benefit people with asthma, who currently receive suboptimal care and demonstrate low medication adherence. This study aimed to explore the perspectives of adults with asthma on the potential for pharmacist-led adherence support delivered in general practice, with a focus on how these perspectives are formed.

Design and setting The study was conducted in the United Kingdom (UK) utilising a qualitative interview methodology. Participants were invited to partake in a telephone-based semistructured interview, followed by an online questionnaire for demographic details and asthma history. Qualitative data were analysed using thematic analysis.

Participants Participants (n=17) were adults with asthma in the UK with a prescription for an inhaled corticosteroid. Participants did not have previous experience with GPPs and were asked to provide their views on a proposed GPP-led service.

Results Participant perspectives of GPPs were determined by trust in pharmacists, perceived gaps in asthma care and the perceived strain on the NHS. Trust was based on pharmacists’ perceived clinical competency, established over time, and gauged through a ‘benchmarking’ process. GPP’s fit in current asthma care was assessed based on potential role overlap with other healthcare professionals, continuity of care and medication-related support needs. Participants navigated the NHS based on a perceived hierarchy of healthcare professionals (general practitioners on top, nurses, then pharmacists), and this influenced their perspectives of GPPs.

Conclusion While the GPP scheme shows promise based on the perspectives of people with asthma, the identified barriers to optimal patient engagement and service implementation will need to be addressed for the service to be effective.

  • medication adherence
  • asthma
  • pharmaceutical services
  • general practice
  • medication therapy management

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjopen-2019-032084

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    Footnotes

    • Twitter @marissames1

    • Contributors The study was designed by MAM, RH and SJCT. All interviews were conducted by MAM. Data was analysed by MAM and CBK. The manuscript was written by MAM, AHYC and VW, with input from RH and SJCT.

    • Funding The research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care North Thames at Barts Health NHS Trust.

    • Disclaimer The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.

    • Competing interests None declared.

    • Patient and public involvement statement All study materials were reviewed by the AUKCAR Patient Advisory Group

    • Patient consent for publication Not required.

    • Ethics approval The research was approved by the NHS London-Harrow Research Ethics Committee (12 October 2017, Ref: 17/LO/1565) and Cwm Taf University Health Board (17 November 2017, Ref: CT/831/205928/17).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.