TY - JOUR
T1 - Expanding pharmacists’ roles
T2 - Pharmacists’ perspectives on barriers and facilitators to collaborative practice
AU - Lott, Breanne E.
AU - Anderson, Elizabeth J.
AU - Villa Zapata, Lorenzo
AU - Cooley, Janet
AU - Forbes, Stephanie
AU - Taylor, Ann M.
AU - Manygoats, Teresa
AU - Warholak, Terri
N1 - Funding Information:
Funding: This work was supported by the grant or cooperative agreement number CTR041521, funded by the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC or the Department of Health and Human Services. This work was also supported by Tabula Rasa OpCo and Arizona Department of Health Services (ADHS14-072992). The funding bodies did not have any role in the study design, collection, analysis, or interpretation of the findings, or writing of the report. Both funding bodies have reviewed the final manuscript.
Funding Information:
Disclosure: Breanne E. Lott, Elizabeth J. Anderson, Lorenzo Villa Zapata, Ann M. Taylor, and Terri Warholak received funding from SinfoniaRx, Inc. Elizabeth J. Anderson, Ann M. Taylor, and Terri Warholak received funding from the Arizona Department of Health Services, Pharmacy Quality Alliance, and Merck Sharp & Dohme Corp, a subsidiary of Merck & Co, Inc, Kenilworth, NJ. Stephanie Forbes is an employee of Tabula Rasa OpCo. Ann M. Taylor discloses that this work was completed previously during her employment at the University of Arizona. The authors declare no other relevant conflicts of interest or financial relationships.Funding: This work was supported by the grant or cooperative agreement number CTR041521, funded by the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC or the Department of Health and Human Services. This work was also supported by Tabula Rasa OpCo and Arizona Department of Health Services (ADHS14-072992). The funding bodies did not have any role in the study design, collection, analysis, or interpretation of the findings, or writing of the report. Both funding bodies have reviewed the final manuscript.
Funding Information:
Disclosure: Breanne E. Lott, Elizabeth J. Anderson, Lorenzo Villa Zapata, Ann M. Taylor, and Terri Warholak received funding from SinfoniaRx, Inc. Elizabeth J. Anderson, Ann M. Taylor, and Terri Warholak received funding from the Arizona Department of Health Services , Pharmacy Quality Alliance, and Merck Sharp & Dohme Corp, a subsidiary of Merck & Co, Inc, Kenilworth, NJ. Stephanie Forbes is an employee of Tabula Rasa OpCo. Ann M. Taylor discloses that this work was completed previously during her employment at the University of Arizona. The authors declare no other relevant conflicts of interest or financial relationships.
Publisher Copyright:
© 2021
PY - 2021/3/1
Y1 - 2021/3/1
N2 - Objective: The pharmacy profession is shifting from transactional dispensing of medication to a more comprehensive, patient-centered model of care. Collaborative practice agreements (CPAs) extend the role of a pharmacist to initiate, monitor, modify, and discontinue drug therapies and provide other clinical services. Although collaborative practice has been shown to improve health system efficiency and patient outcomes, little is known about how pharmacists perceive CPAs. To explore pharmacists’ perspectives of CPAs, including barriers and facilitators to CPA implementation. Methods: Semistructured key informant interviews were used to elicit information from licensed pharmacists practicing in a variety of settings in Arizona. Thematic analysis was used to identify key qualitative themes. Results: Seventeen interviews of pharmacists with (n = 11, 64.7%) and without (n = 6, 35.3%) CPAs were conducted in April-May 2019. The pharmacists saw their role in CPAs as supportive, filling a care gap for overburdened providers. A heightened sense of job satisfaction was reported owing to increased pharmacist autonomy, application of advanced knowledge and clinical skills, and ability to have a positive impact on patients’ health. Challenges to the implementation of CPAs included liability and billing issues, logistic concerns, some experiences with provider hesitancy, and lack of information and resources to establish and maintain a CPA. The barriers could be overcome with conscious team-building efforts to establish trust and prove the worth of pharmacists in health care teams; strategic engagement of stakeholders in the development of CPAs, including billing and legal departments; and mentorship in the CPA creation process. Conclusions: The pharmacists in this study enjoyed practicing collaboratively and had overall positive perceptions of CPAs. As health worker shortages become more dire and pharmacy practice evolves to expand the role of pharmacists in providing direct patient care, CPAs will be an important tool for restructuring care tasks within health systems.
AB - Objective: The pharmacy profession is shifting from transactional dispensing of medication to a more comprehensive, patient-centered model of care. Collaborative practice agreements (CPAs) extend the role of a pharmacist to initiate, monitor, modify, and discontinue drug therapies and provide other clinical services. Although collaborative practice has been shown to improve health system efficiency and patient outcomes, little is known about how pharmacists perceive CPAs. To explore pharmacists’ perspectives of CPAs, including barriers and facilitators to CPA implementation. Methods: Semistructured key informant interviews were used to elicit information from licensed pharmacists practicing in a variety of settings in Arizona. Thematic analysis was used to identify key qualitative themes. Results: Seventeen interviews of pharmacists with (n = 11, 64.7%) and without (n = 6, 35.3%) CPAs were conducted in April-May 2019. The pharmacists saw their role in CPAs as supportive, filling a care gap for overburdened providers. A heightened sense of job satisfaction was reported owing to increased pharmacist autonomy, application of advanced knowledge and clinical skills, and ability to have a positive impact on patients’ health. Challenges to the implementation of CPAs included liability and billing issues, logistic concerns, some experiences with provider hesitancy, and lack of information and resources to establish and maintain a CPA. The barriers could be overcome with conscious team-building efforts to establish trust and prove the worth of pharmacists in health care teams; strategic engagement of stakeholders in the development of CPAs, including billing and legal departments; and mentorship in the CPA creation process. Conclusions: The pharmacists in this study enjoyed practicing collaboratively and had overall positive perceptions of CPAs. As health worker shortages become more dire and pharmacy practice evolves to expand the role of pharmacists in providing direct patient care, CPAs will be an important tool for restructuring care tasks within health systems.
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U2 - 10.1016/j.japh.2020.11.024
DO - 10.1016/j.japh.2020.11.024
M3 - Article
C2 - 33359117
AN - SCOPUS:85098670127
SN - 1544-3191
VL - 61
SP - 213-220.e1
JO - Journal of the American Pharmacists Association
JF - Journal of the American Pharmacists Association
IS - 2
ER -