Family physicians' perceptions of pharmacists prescribing in Alberta.

Canadian pharmacists now have prescribing authority and little is documented about the physicians' perception, experience and relational dynamics evolving around the pharmacists' prescribing practice. The objective of this study was to explore Albertan family physicians' perceptions and experiences of pharmacists' prescribing practice. We used purposeful and maximum variation sampling method and semi-structured face to face or telephone interviews to collect data. From October 2014 to February 2016, we interviewed 12 family physicians in Alberta, having experience with pharmacist prescribing. Interviews were audio recorded and transcribed verbatim for analysis using an interpretive description method, guided by "Relational Coordination" theory. NVivo software was used to manage the data. Three key beliefs (i.e., renewal versus initiate new prescription, community versus team pharmacists, and "I am responsible") about pharmacist prescribing were identified. Trust and communication were prominent themes which shaped participants' collaboration with pharmacist prescribers. Participants were classified as either "collaborative" or "consultative". Participants had greater collaboration with the team pharmacist prescribers compared to community pharmacists due to a higher level of trust and ease of communication. Renewal prescribing by any pharmacist was well accepted but participants showed hesitancy in accepting pharmacist-initiated prescriptions. Our findings provide insight into interprofessional collaboration and communication between physician and pharmacist prescribers.

Family Physician's and Primary Care Team's Perspectives on Supporting Family Caregivers in Primary Care Networks.

BACKGROUND: Research, practice, and policy have focused on educating family caregivers to sustain care but failed to equip healthcare providers to effectively support family caregivers. Family physicians are well-positioned to care for family caregivers. METHODS: We adopted an interpretive description design to explore family physicians and primary care team members' perceptions of their current and recommended practices for supporting family caregivers. We conducted focus groups with family physicians and their primary care team members. RESULTS: Ten physicians and 42 team members participated. We identified three major themes. "Family physicians and primary care teams can be a valuable source of support for family caregivers" highlighted these primary care team members' broad recognition of the need to support family caregiver's health. "What stands in the way" spoke to the barriers in current practices that precluded supporting family caregivers. Primary care teams recommended, "A structured approach may be a way forward." CONCLUSION: A plethora of research and policy documents recommend proactive, consistent support for family caregivers, yet comprehensive caregiver support policy remains elusive. The continuity of care makes primary care an ideal setting to support family caregivers. Now policy-makers must develop consistent protocols to assess, and care for family caregivers in primary care.