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Perceptions of pharmacists' integration into patient-centered medical home teams.
Res Social Adm Pharm. 2015 Jan-Feb; 11(1):85-95.RS

Abstract

BACKGROUND

Patient-centered medical homes (PCMHs) are a newer paradigm of health care service delivery. Team-based care that includes pharmacists has been implemented in several countries. Subsequently studies have successfully identified challenges and barriers with team-based care. Research on pharmacists' integration into PCMH is warranted to help bridge knowledge from earlier studies exploring team-based care. In 2010, the Department of Veteran Affairs (VA) began a national PCMH implementation, operationalized as "Patient-Aligned Care Teams" (PACTs). The VA's national PACT implementation presents an opportunity to describe other persistent barriers to effective coordination between primary care and pharmacy providers.

OBJECTIVE

To identify perceived barriers and facilitators to pharmacist integration into VA PACTs from the perspective of non-pharmacist team members.

METHODS

Semi-structured interviews were conducted as part of a formative evaluation of PCMH implementation. Participants were from VA medical centers and community-based outpatient clinics in the Midwestern United States and included physicians, nurses, associated health care professionals, and health system administrators.

RESULTS

In working toward pharmacy service integration, role clarity and work activities were influenced by team member attitudes toward and previous experiences with pharmacists. Interviewees reported that coordination with pharmacists was hindered if communication placed extra burdens on other team members. Interviewees reported collaboration was easier when pharmacists were onsite, but that technology helped facilitate off-site access to pharmacy services. Finally, some team members characterized pharmacist integration as essential while others failed to integrate pharmacists at all.

CONCLUSION

Non-pharmacist members of PACT teams reported some reluctance in pharmacists' integration. They attributed this reluctance to knowledge deficits, limited participation in PACT training by pharmacists, an imbalance in effort expended for pharmacists' integration, and coordination or communication challenges. While there may be unique opportunities for pharmacists to improve patient care through participation in PCMHs, work remains to improve other health professionals' knowledge of and attitudes toward pharmacists' roles on health care teams.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Patterson BJ
University of The Sciences, Philadelphia College of Pharmacy, Philadelphia, PA 19104, USA.
Solimeo SL
US Department of Veteran Affairs, VISN 23 Patient Aligned Care Team Demonstration Lab, Iowa City VA, USA; US Department of Veteran Affairs, Veteran Rural Health Resource Center - Central Region, Iowa City, IA 52246, USA.
Stewart KR
US Department of Veteran Affairs, VISN 23 Patient Aligned Care Team Demonstration Lab, Iowa City VA, USA; US Department of Veteran Affairs, Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA, USA; US Department of Veteran Affairs, Veteran Rural Health Resource Center - Central Region, Iowa City, IA 52246, USA.
Rosenthal GE
US Department of Veteran Affairs, VISN 23 Patient Aligned Care Team Demonstration Lab, Iowa City VA, USA; US Department of Veteran Affairs, Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA, USA; University of Iowa College of Medicine, Iowa City, IA 52242, USA; University of Iowa College of Public Health, Iowa City, IA 52242, USA.
Kaboli PJ
US Department of Veteran Affairs, Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA, USA; US Department of Veteran Affairs, Veteran Rural Health Resource Center - Central Region, Iowa City, IA 52246, USA; University of Iowa College of Medicine, Iowa City, IA 52242, USA.
Lund BC
US Department of Veteran Affairs, Center for Comprehensive Access & Delivery Research and Evaluation, Iowa City VA, USA; US Department of Veteran Affairs, Veteran Rural Health Resource Center - Central Region, Iowa City, IA 52246, USA; University of Iowa College of Public Health, Iowa City, IA 52242, USA. Electronic address: brian.lund@va.gov.

MeSH

HumansPatient Care TeamPatient-Centered CarePerceptionPharmacistsProfessional Role

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

24954185

Citation

Patterson, Brandon J., et al. "Perceptions of Pharmacists' Integration Into Patient-centered Medical Home Teams." Research in Social & Administrative Pharmacy : RSAP, vol. 11, no. 1, 2015, pp. 85-95.
Patterson BJ, Solimeo SL, Stewart KR, et al. Perceptions of pharmacists' integration into patient-centered medical home teams. Res Social Adm Pharm. 2015;11(1):85-95.
Patterson, B. J., Solimeo, S. L., Stewart, K. R., Rosenthal, G. E., Kaboli, P. J., & Lund, B. C. (2015). Perceptions of pharmacists' integration into patient-centered medical home teams. Research in Social & Administrative Pharmacy : RSAP, 11(1), 85-95. https://doi.org/10.1016/j.sapharm.2014.05.005
Patterson BJ, et al. Perceptions of Pharmacists' Integration Into Patient-centered Medical Home Teams. Res Social Adm Pharm. 2015 Jan-Feb;11(1):85-95. PubMed PMID: 24954185.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perceptions of pharmacists' integration into patient-centered medical home teams. AU - Patterson,Brandon J, AU - Solimeo,Samantha L, AU - Stewart,Kenda R, AU - Rosenthal,Gary E, AU - Kaboli,Peter J, AU - Lund,Brian C, Y1 - 2014/05/29/ PY - 2014/02/04/received PY - 2014/05/14/revised PY - 2014/05/15/accepted PY - 2014/6/24/entrez PY - 2014/6/24/pubmed PY - 2015/11/13/medline KW - Health care teams KW - Patient-centered medical home KW - Pharmacy services KW - Veteran affairs SP - 85 EP - 95 JF - Research in social & administrative pharmacy : RSAP JO - Res Social Adm Pharm VL - 11 IS - 1 N2 - BACKGROUND: Patient-centered medical homes (PCMHs) are a newer paradigm of health care service delivery. Team-based care that includes pharmacists has been implemented in several countries. Subsequently studies have successfully identified challenges and barriers with team-based care. Research on pharmacists' integration into PCMH is warranted to help bridge knowledge from earlier studies exploring team-based care. In 2010, the Department of Veteran Affairs (VA) began a national PCMH implementation, operationalized as "Patient-Aligned Care Teams" (PACTs). The VA's national PACT implementation presents an opportunity to describe other persistent barriers to effective coordination between primary care and pharmacy providers. OBJECTIVE: To identify perceived barriers and facilitators to pharmacist integration into VA PACTs from the perspective of non-pharmacist team members. METHODS: Semi-structured interviews were conducted as part of a formative evaluation of PCMH implementation. Participants were from VA medical centers and community-based outpatient clinics in the Midwestern United States and included physicians, nurses, associated health care professionals, and health system administrators. RESULTS: In working toward pharmacy service integration, role clarity and work activities were influenced by team member attitudes toward and previous experiences with pharmacists. Interviewees reported that coordination with pharmacists was hindered if communication placed extra burdens on other team members. Interviewees reported collaboration was easier when pharmacists were onsite, but that technology helped facilitate off-site access to pharmacy services. Finally, some team members characterized pharmacist integration as essential while others failed to integrate pharmacists at all. CONCLUSION: Non-pharmacist members of PACT teams reported some reluctance in pharmacists' integration. They attributed this reluctance to knowledge deficits, limited participation in PACT training by pharmacists, an imbalance in effort expended for pharmacists' integration, and coordination or communication challenges. While there may be unique opportunities for pharmacists to improve patient care through participation in PCMHs, work remains to improve other health professionals' knowledge of and attitudes toward pharmacists' roles on health care teams. SN - 1934-8150 UR - https://www.unboundmedicine.com/medline/citation/24954185/Perceptions_of_pharmacists'_integration_into_patient_centered_medical_home_teams_ DB - PRIME DP - Unbound Medicine ER -